IT Band

July 30, 2011

I have treated more patients than normal in the last two years with iliotibial (IT) band pain. Commonly referred to as IT Band Friction Syndrome. It is not really a mystery like syndromes indicate.

The IT Band is not muscle, but is actually a fascial band of tissue. Think of the white stuff that is between the skin and meat of chicken. It’s purpose is to provide support between the hip and the knee. It even provides some support to the outside of the knee in some cases.

When the IT Band is tight it causes the band to rub over a boney projection at the knee. Repeated flexion and extension of the knee causes repeated rubbing (think irritating blister on your foot). Some of this could be related to what I talked about yesterday with the hip. For this reason I encourage runners to strengthen their hips.

Pain from IT Band Friction is usually over the outside of the knee and is painful after running. You should notice this pain gradually increasing. The best thing to do when you are experiencing this pain is to stop running. Invariably I can predict when a patient has IT Band pain simply by the questions that I ask: When does it hurt? Running? Stairs? Hills? Yes. Avoiding running, especially hills is necessary. If the pain is not heeded soon enough it could require the use of a knee immobilizer to keep the knee from bending and irritating the IT Band further.

So what do we do about it? For one thing, strengthen the hips. They are generally weak and it gives us a chance to calm down the area. I use techniques to loosen the IT Band as well. Graston and self-myofascial release with a foam roller are two excellent tools. Some people tolerate these better than others, but they are so important. The last and probably most long term solution is IT Band stretching.

Try this: Lay down on your side on the floor. Bend the knee that is on top and lower it to the ground. Now place your other foot on top of that knee. Another thing that you can do is to put something under your hip before you lie down. There are a number of stretches that can be used. This is just one, but is one of my favorites.

Sometimes I advise the use of NSAIDs (Ibuprofen, Advil, or Aleve) to help to get the pain under control. I do not advise this to push through running!

As you get back into running you need to do it gradually and on flat surfaces. The last thing you want to do is get it better and go out for a 5 mile hill run. You will be back at square one in no time. Begin on a track and doing jogging. Any pain and you stop. Build up your mileage and then add a few hills. It is something that you must do right or you will not break out of the injury and will be frustrated.

As always, I am not your doctor and would advise you to check with your doctor before you begin exercise or have an injury. This information can be used in conjunction with the recommendations of your doctor.


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