IT Band Syndrome (ITBS) is one of the most common overuse injuries that a runner has to deal with (and one of the most agonizing). Those of us that have experienced ITBS know this all too well. You’re out for a run, feeling good and enjoying the scenery, and then all of a sudden, you feel a twinge in the outside of your knee. Eh, it will be fine, right – I’ll just finish my run and then stretch it out. 2 minutes later, it feels like someone is jabbing the outside of your knee with a screwdriver, and the pain is so acute that you have to stop running.
In order to understand what’s going on here, let’s first talk about what the IT band is and its role in your running.
WHAT IS THE IT BAND?
The IT band runs along the outside of the thigh, from just above the hip to just below the knee, and is made up of fascia, an elastic connective tissue found throughout the body.
The IT band attaches to some pretty important muscles – glutes (which work to keep the body upright – kind of important), and tensor fascia latae (hip muscle that helps stabilize the pelvis – also kind of important). It runs down the outside of your thigh and attaches to the tibia, helping to control the angle of your lower leg as you run.
Just above the knee, a fluid-filled sac called a bursa sits sandwiched between the IT band and the femur (along with some fat, bone, and connective tissue). In an ideal world, the bursa is nicely snuggled in there, receiving the perfect amount of pressure as you strike the ground during the run.
But in the case of ITBS, tightness (or weakness – we’ll get to that later) leads to abnormal movement of the pelvis and femur. This then causes the IT band to compress into the outer side of the femur when the knee is flexed – putting a TON of pressure on that nice delicate bursa as well as the tissue around it. It’s no longer being snuggled; it’s being positively squeezed. BOOM, inflammation and pain.
You can see the important attachment points of the IT band – now it should make sense why glute strength & flexibility is so important!
How many times have you heard someone say ‘Oh man, my IT bands are really tight?’ This statement doesn’t tell the whole story. According to a lot of experts in sports medicine, the connective tissue that makes up the IT Band is as strong as Kevlar (the material that is used in bulletproof vests). So the IT band actually should be ‘tight,’ and trying to stretch it is an exercise in futility. What is usually causing the band to compress against the femur and give you that terrible pain is tightness, yes, but tightness in the glutes and TFL – those oh-so-important muscles we mentioned above.
HOW DO I TREAT ITBS?
What does any runner hate to hear? Stop running. Well, sorry folks. With this one in particular, you do need to stop running for a bit, at least during the acute injury phase (when you’re in pain).
While you’re taking this important rest time, ICE is key. Do about 15 minutes on, 3 or 4 times per day to work on reducing the inflammation that has built up. Once you’ve gotten past that initial sharp pain, start mixing in low-impact cross training like cycling or pool running.
Once you’ve gotten the pain under control, then we start looking at stretching and strengthening, which brings us to…
ITBS PREVENTION & THE TRUTH ABOUT FOAM ROLLING
The foam roller is one of the best tools to help you fend off overuse injuries and stay strong as a runner. There has, however, been mixed messaging in recent years regarding foam rolling your IT band. For awhile, the message was, ‘roll out your IT Band and you’ll feel better. It will hurt A LOT, but will help you in the long run.’
But a lot of clinicians have turned that around a bit. Because the IT band is tough and basically has the consistency of a tire (and is supposed to be tight), your focus when stretching and foam rolling should be on the supporting muscles – hamstrings, quads, glutes, and hips. Our friends at Trigger Point have put together some great resource videos – this one (above) helps explain how to get at those hip muscles to keep your IT band functioning as it should. Give it a watch!
In addition to foam rolling, work on some strength exercises to keep the glutes and hips strong – this will put you in a better position to avoid IT band injury in the future. Our friend Mike Silva of Foundation Performance Sports Medicine demonstrates some glute strength exercises – click HERE to view the video.
And as always, feel free to visit any of our store locations to chat about stretching, strengthening, and anything else you could be doing to keep this monster at bay!
Information for this post was adapted from RUNNING STRONG by Dr. Jordan Metzl and INJURY-FREE RUNNING by Dr. Thomas Michaud
