IT BAND SYNDROME: AN OVERVIEW
Among the physically active, in particular runners, IT band syndrome is a common nagging injury that can be quite painful and tedious to deal with. Understanding anatomy and biomechanics a little bit better is a great place to start when looking for relief and prevention of IT band syndrome.
IT BAND ANATOMY
First let’s delve into the anatomy. The IT Band is a long thick band of connective tissue that runs along the outside (lateral) of the upper leg (femur). This band of tissue originates from a muscle called the tensor fascia latae, a muscle on the outside of the hip that assists with rotation, flexion, and abduction. While the muscle is not a prime mover it is definitely important in stabilizing the hip during those respective actions. The IT band then runs down the femur and crosses the knee joint to connect at the top of your tibia bone on a point called gerdy’s tubercle. The IT band is thick and taught by nature (remember this for later on!).
Now let’s think about what happens to the IT band with movement, specifically at the knee joint. The band crosses the knee joint with little to no protective cartilage or tissue between it and the lower femur and upper tibia. If someone was to perform repetitive motions with poor biomechanics this would cause a lot of friction over time and thus inflammation and pain.
This is true with most cases of chronic tendinous injuries. They are the result of something being done repetitively over time with little rest and biomechanics may not even have to bee poor for this to happen. There can be acute bouts of tendinitis as well caused by just poor biomechanics with high intensity exercise. Think about not playing a sport for a long time and then diving right into it one day randomly with no prep. If I were to play pick up racquetball after years of not playing I would probably be stubborn and go too hard and long, resulting in a very sore elbow.
IS THERE RELIEF?
Is there relief for IT band syndrome? Of course there is! Depending on severity, immediate treatments include; rest, ice, NSAID’s, heat. However, to get back to activity we should probably think about what caused the pain in the first place. If you’re an avid runner and you run on roads you probably stick to running on the same side of the road (the right side). Road running is about as uneven as it gets in most places due to roads having a natural slope outward. Consider finding a trail or more even path to run on if this is the case.
Shoes being worn out and unsupportive is always a concern for runners. The easiest way to determine if you need new running shoes is to check the treads. If they are quite worn you are due!
If shoes and road running are not issues for you then there could be a weakness in your hips and core causing poor running mechanics. There are tons of resources available for hip specific strengthening and core strengthening online. However, just know that you don’t need to search for “running specific core and hip exercises”. Simple and effective strengthening exercises like loaded squats, hinges, and bridges are great for the hips. I do think there is benefit to adding in banded hip work like hip flexor marches, hip external and internal rotations to help strengthen the smaller and deeper hip muscles.
Plank and side plank variations that you can progress with added movements work for core “stability” and bear crawls and inchworms are full body core options that require some coordination and have an added bonus of mobility being worked on.
Remember that IT Band Syndrome is probably the result of too much frequency or intensity in your running or activity. This doesn’t mean we need to shut down completely, that’s something to decide with your physician or physical therapist based on pain levels and quality of life. There are plenty of ways to stay active and ease back into running. Consider swimming and biking if you have access to either.
STAY HEALTHY MY FRIENDS - COACH TOM