Iliotibial band pain is enough to bring a full grown adult to a crumpled mass of human on the side of the road in the middle of an 18 mile training run. I know all too well. Both from a personal and professional standpoint, Iliotibial bands (IT Bands) can become painful and problematic. But with a little knowledge in self care and knowing when to seek help, the IT bands can serve you well, pain free.
This structure crosses the hip and the knee joint. It begins at the Ilium, or the top of the pelvis, and travels down the tibia, the larger bone in the lower leg. Opportunities for friction arise at the bony protuberance at the side of the upper leg near the hip (the greater trochanter), and also at the outside of the knee. Depending on your body mechanics, it can be most painful at either of these points. Often intense knee pain at the side of the knee is due to inflammation and irritation at the end of the IT band. This structure is a fairly dense yet elastic fibrous tissue, responsible for stabilizing the hip and knee.
Common causes of IT band syndrome:
- Weak hips: gluteus medius, maximus, and hip rotators are key factors in controlling the motion of the pelvis and the knee during running and truly all motions on feet. If the hip muscles are weak, it causes increased stress to the structures “down stream” or below the hip, and because the IT band assist in stability, it can become overused and irritated. To strengthen these muscles, check out my leg strengthening workout: http://www.runningyourbody.wordpress.com/2013/03/10/on-leg-strength/
- Poor foot mechanics: when the feet are overly flattened, they are referred to as pronated. Over-pronation can lead to increased strain not only in the feet, but in the knee, particularly in the IT band. Foot strengthening exercises are a great way to manage this, particularly a towel scrunching exercise in which you grasp your toes around a towel, hold 5 sec, relax, and repeat 10x. Orthotics are commonly prescribed to treat this condition, though I am always very hesitant to recommend orthotics or motion control shoes to people without first trying to strengthen the feet and legs. The reason for this is that if you can actually fix the mechanical problem, I find it preferable to masking the issue with external restraints. If you have chronic instability in the foot due to fractures or ankle sprains, it may be difficult to correct your foot position with exericse. See a physical therapist that specializes in running or orthopedics for recommendations for your specific condition.
- Heavy Foot contact: if you are a “noisy” runner or walker, you may be introducing increased forces through your legs, thus irritating your knees, hips, and IT bands. Try to contact the ground softly. It helps to focus on a point approximately 40 feet away, and try to stabilize your gaze, no allowing your head to bob above or below it.
- Other Biomechanical Issues: There are anatomical and mechanical deviations that lead to IT band irritation and pain. If you have chronic pain, see a physical therapist specializing in running gait that can break down your mechanics and help you address any deficiencies in order to end It band pain once and for all.
There are some home treatment measures that may help. They include:
- Foam Rolling: use a foam roller to roll out your IT bands, Quadriceps, Hamstrings, and shins. It will not be comfortable! In fact, if your IT bands are tight, this will be highly uncomfortable, but the more you foam roll, the better it will be, so keep at it! Foam roll from the top of the hip, to the base of the knee, at least 10 passes up and down on each leg.
2. Ice the IT bands: you can use frozen peas, or if you are very brave, fill your bathtub with ice and hop in for 6-8 minutes
3. Stretch: Researching on stretching is inconclusive at this point as to how effective it is in elimination or prevention of injury. There is some evidence supporting stretching after exercise, thus, it is recommended and worth your time to stretch following a run, 30 seconds each leg per stretch. Here is an example of an IT band stretch:
4. Strengthen the Legs: as discussed earlier, keep your gluteal and abdominal muscles strong to maintain control of the hips. Follow my Leg strengthening workout at: http://www.runningyourbody.wordpress.com/2013/03/10/on-leg-strength/
As always, this is not meant to replace a recommendation by your physician or physical therapist. If your pain does not subside after 6 weeks, see a health care provider. If you are in Southern Oregon, come see me, I’m happy to help.
Take care of your body, and make your day great!