IT band syndrome is a common complaint for runners, especially those who are getting back into their sport after a winter hiatus. As you dust the cobwebs off your running shoes and step outside into the spring air, remember these tips and you may prevent a season ending injury.
What is IT Band Syndrome?
The Iliotibial Band, or ITB, is a strip of fascia, or tissue, connecting the muscles of your hip and thigh to the outside of the knee joint. This band is formed at the top by gluteus maximus (back) and tensor fascia latae (front), runs down the outside thigh between the hamstring (back) and the quadriceps (front), and then attaches to a bony prominence at the knee.
Because of its location between a bunch of muscles, the IT Band is an important stabilizing structure and can also be pulled in a number of different directions when there is imbalance in muscle strength. Studies show that weakness in the gluteus maximus and medius contribute to ITB syndrome and I will take that one step further and say that this weakness contributes to an overuse of the lateral quad and hamstring. So for those of you who need simple:
weak butt + tight thigh = IT band problem
So what are the signs of ITB syndrome and how do you deal with it. The signs of ITB syndrome are a tight, sore lateral thigh (quad and ITB), sore upper front hip (tensor fascia latae), and sore lateral knee. A tight IT band can also pull the knee cap out of place and lead to some pain over the outside or inside border of the knee cap.
How do you deal with IT band syndrome?
First, make sure your shoes are supporting your arch. If you have a pair that has logged >500 miles, has broken laces, and a hole in the toe, um, yeah. Second, if it’s continually sore, you need some activity modification. Decrease your mileage and time to a point where there is minimal flare-up. Minimal flare-up means your pain is 2-3/10 at most, you don’t have to limp while running, and pain recovery is 24 hours or less. Also consider running on flat ground, as hills require more from your gluts and if you don’t have any, well, your IT band is going to flare up. And, last, if you can’t walk without pain, how should I say this, THEN YOU SHOULDN’T BE RUNNING. Sorry, but it’s true. Better to take a 2 week break and do some Physical Therapy than be out for a season with a pesky ITB problem. Trust me, it can be a season ender for the stubborn athlete.
To deal with acute IT band flare-ups you need to ice, stretch, and roll on a foam roller. Ice massage is better than an ice pack as it induces some tissue remodeling and circulatory flow, which is limited in tissue like the IT band. Stretching the IT band is hard and the best stretch I have found is reverse triangle pose. Foam rolling the IT band hurts like a you-know-what, but it is effective in the short term so do it.
To get rid of IT band syndrome, you need to keep stretching and rolling, add a good quad and hip flexor stretch, and then you need to strengthen your gluts. Bridge, single limb bridge, foam roll bridge, clamshell, squats, single leg squats, and lateral taps or walks are all good options for exercises and are generally progressed in the order listed here. Here’s the tricky part: a lot of these exercises will work your lateral quadriceps and hamstrings and not your gluts if you don’t do them right! This is where your Physical Therapist comes in. A good PT knows how to cue a patient to ensure they are activating the right muscles in the right positions so they don’t do more harm than good. A few of the exercises above are demoed in photo and video format but please don’t hesitate to give us a call and make an appointment if the exercises flare you up or you just feel like you need some guidance. The PT’s at MoveMend would love to help! Call at 206-641-7733 or schedule an appointment here!
Written by Dr. Ryan Simmons