Common Injuries in Runners: IT Band Pain
Summary:
Iltiotibial band syndrome is one of the most common overuse injuries in runners, cyclists, and weightlifters, resulting in pain to the outside portion of the knee.
Anatomy & Function:
The iliotibial band, commonly known as the IT band, is named for its attachments to the ilium, which is part of the pelvis, and the tibia, known as the shin bone. It is a thick band of fascia that runs on the outside on your thigh from the hip to just below the knee.
The IT band is a type of connective tissue that is different from muscle, tendon, or ligaments. It does not perform muscle contractions, but it does act as a casing contributing to the stability of the hip and knee by storing and releasing energy during activities such as walking and running.
https://www.physio-pedia.com/Iliotibial_Band_Syndrome
Myths:
A tight IT band was previously blamed for this pain. It was believed that you needed to stretch or foam roll your IT band to break up the scar tissue and release adhesions. Research studies have taken the IT band out of the cadaver and hung it from the ceiling with weights https://pubmed.ncbi.nlm.nih.gov/11796669/ . The IT band does not change lengths. You cannot stretch your IT band.
Rather than foam rolling your IT band, you can try foam rolling the four muscles that attach to the IT band. The muscles are the tensor fascia lata (TFL), gluteus maximus, vastus lateralis (lateral quadricep muscle), and biceps femoris (lateral hamstring muscle). Check out THIS video for how to foam roll these muscles.
Remember that foam rolling is NOT the solution to the issue, but it can be a positive addition to overall treatment to assist in pain modulation, tissue extensibility, and exercise recovery.
Why do I have pain?
Most of the time, there is not one simple clear-cut answer. It is typically due to a combination of weakness and decreased mobility at your hips, ankles, and feet causing increased stress at the knee.
Another primary contributing factor is a large spike in workload or intensity of training. In runners, this looks like increasing your speed, mileage, and/or frequency of runs too quickly. Basically, you do a little too much, a little too soon, and push beyond your current capacity. A key part of rehabilitation will be managing your load.
Exercises:
Exercises will prepare your body for the demands of running and improve the load tolerance of your knee. Here are a few we like to improve the strength and motor control of your hip abductors, extensors, and external rotators.
Suggestions for Runners:
Reduce the intensity, frequency and/or volume of the aggravating activity to a tolerable level. Scale back, but do not rest completely.
While you rehab your knee, minimize downhill running, trail running, and running on uneven surfaces until you are able to run in a straight line on flat ground comfortably.
In the meantime, incorporate other forms of cross-training to maintain your fitness, and begin the resistance exercises linked.
A simple strategy to potentially decrease the load on your knee while running is to increase your cadence by 5-10%, which will shorten your stride length and decrease the strain on the IT band.
Conclusion:
Bulletproof Physical Therapy is about more than just alleviating your pain. We want to move you from injured to healthy and ready to take on your next PR or race! Our comprehensive approach will get you out of pain and provide you with the tools to remain pain free for years to come!
Are you ready to become a stronger, healthier, and happier runner? The first step is getting in touch!
Click HERE to schedule a free discovery call!
