What You Should Know About IT Band Syndrome
Preventing injury is what we should all strive for. When participating in a repetitive sport like running, prevention is essential. Unfortunately, when you place your body under the amount of stress that running requires, injuries are a plausible outcome regardless of efforts to prevent them.
One of the most common overuse injuries for runners is iliotibial band syndrome. You’ve all heard of it before and maybe even experienced it but what is it, what causes it and how can it be treated?
Symptoms of IT Band Syndrome
Classically, IT band syndrome presents as pain on the outer portion of the knee just prior to or during knee extension that gradually increases. Typically, it’s aggravated the most during downhill running but that’s not always the case. A squeaking sound or feeling may even be present during knee extension. Think Tinman before the oil.
What causes IT Band Syndrome?
The iliotibial (IT) band is a thick band of connective tissue on the side of the upper leg. What most people don’t realize is the IT band is a tendinous extension of a small muscle called the tensor fascia lata, or TFL and the gluteus maximus. The TFL is the muscle that predominantly controls the tension of the IT band.
When the TFL contracts, the IT band tightens and vice versa. The TFL originates at the side of your hip bone and seamlessly changes into the IT band which continues down the outside of the thigh and inserts into the side of the knee.
Images courtesy of Visible Body®
When the IT band is tight, it rubs over a bony bump in your knee. This causes friction and leads to inflammation which causes pain. Too often, treatment is directed at the symptomatic IT band, when the source of the problem is actually the TFL.
Typically, the TFL becomes tight due to repetitive use while running, as it uses the IT band to aid in knee extension. There can also be other underlying reasons for IT band tightness, like excessive inward rolling of the ankles and arches or muscle weakness.
How to Treat IT Band Syndrome
The location of the TFL makes it somewhat difficult to perform any self-treatment, such as stretching. Below is a helpful stretch for the TFL and IT band. Feeling the stretch at the hip and/or down through the knee is the key. If you can’t quite feel the stretch in this position, try slightly changing the position of your torso.
It is possible that the TFL and IT band are too fibrotic. If this is the case, stretching may not alleviate your symptoms and treatment of the tissue will be necessary.
As is usually the case, massage, rest and ice are helpful treatment options but I do not recommend the use of a foam roller. Typically, strengthening of the glutes, abductors, hamstrings and quadriceps may be necessary as well. When using ice, place it at the knee on the site of the pain.
I have personally found chiropractic adjustments, strengthening exercises, stretching, Graston Technique® and Active Release Technique® to be quicker, more effective treatments for IT band syndrome.
It is important to focus any treatment at the cause of the problem rather than just treating the symptoms. I recommend seeing someone who is trained in evaluating these types of injuries, such as a chiropractor or physical therapist, in order to uncover and treat the source of the issue.