The Mystery Behind IT Band Injuries
From the desk of licensed massage therapist, Kristen Lutz... “Pain along the outside of my knee”... “Pain along the outside of my thigh”... “It’s worse when I go up stairs”... “It’s worse when I go down stairs”... “It gets worse when I run downhill”... “It hurts to get out of my car”. These are some common things I hear when listening to massage therapy clients who are exuding symptoms of an injured or stressed iliotibial (IT) band. I use the term injured or stressed rather than the conventional term of “Iliotibial (IT) band syndrome” because, in my experience, that more accurately depicts what is really going on. Let me explain.
The iliotibial (IT) band is a sheath of thick, fibrous connective tissue that runs along the outside of both thighs. Think of it as one giant tendon/ligament. Its job is to support extension of the knee joint (straighten it) and abduction of the hip (move out sideways). It attaches at the top of the iliac crest (hip bone) and blends into a muscle that flexes the hip called the tensor fascia latae (TFL) and gluteus maximus muscle, travels down the side of your thigh (covering a portion of your quad muscle known as the vastus lateralis), crosses the outside of your knee joint and inserts just below your knee to your tibia (one of two shin bones). Holy moly, what does all that mean??What that means is that when you find yourself with pain or discomfort in your IT band the most likely culprit is something other than the IT Band itself. Oftentimes, where we feel the pain is the symptom of something else that is going on.
Please keep in mind that you should see a qualified health care practitioner to rule out the involvement of other structures at the knee or hip to accurately treat what is going on. This is especially true if you’ve had a recent trauma. After ruling out other injuries, if you keep coming back to IT band pain, here is some food for thought for how to go about ridding your body of this nagging pain once and for all! Evaluate your activity level What demands are you placing on your body? Our bodies are amazing in that they will adapt to whatever stress we put them under. Have to work in front of a computer for 40 hours a week? Your body will adapt its posture to allow you to do that. Want to run 3 miles today? No problem! Your body will step up and do exactly what you ask of it. Just remember that dramatic changes in your exercise intensity, frequency or duration will increase your risk for injury – that includes the IT band. Book a private Pilates session with Lisa or Sharon to create a well-balanced routine for you! Training Regimen What does your training program look like? Over time, have you developed biomechanical imbalances as a result of what you are doing? A very easy example of this is with running. Some runners will only run on one side of the road. Most roads are higher in the center and slope off on either side. The foot that is on the outside part of the road is therefore lower than the other. This causes the pelvis to tilt to one side and stresses the IT band. So try reversing your running route to balance things out. What you put into your body is just as important. See Laura for nutritional counseling to make sure what you are putting into your body is going to support your training regimen! Postural Analysis Having a trained health professional take a look at your gait (walking) and running pattern is worth the investment. They will be able to identify imbalances such as stride length and frequency, how your foot makes contact with the ground, and so on. A thorough structural assessment should follow. This will require hands on testing of the joints and surrounding tissues to better evaluate what soft tissues need to be restored to their normal resting length. The practitioner will also be able to identify leg length discrepancy (i.e. difference in true, anatomical leg length), pelvic tilting or an abnormal rotation at the hips. Book your orthopedic evaluation with Jessica Molleur, our resident acupuncturist!
Footwear Your footwear should be appropriate for your activity and exercise regimen. In some cases, people with ‘falling arches’ or what we call in the ‘biz’ as hyperpronation of the foot causes a domino effect on the structures of the body. Again, that includes the IT band. This can have an ascending affect on your knee, hip, back and even head and neck. Schedule an assessment with Dr. Erik Vose. He also provides free alignment assessment for insoles! So what do you do if you are in what’s called the acute (immediate) phase of injury?
Rule #1: DO NOT STRETCH THE IT BAND! This will only increase the stress and microtrauma to the structure. Rule #2: Rest for a few days... YES you can make it worse! Rule #3: As long as it’s pain-free, perform hip flexor (TFL + quad) and gluteal stretches on the affected side. Hold your stretches for 20-30 seconds. Rule #4: Sleep on your side with a pillow between your legs. This will support your back and hips, while taking pressure off of the IT band.
Sign up for one of Rachael’s yoga series to make sure you are stretching properly!
In general, I do not recommend using a foam roller or massage stick for IT band injuries. The more research that is presented on connective tissues such as ligaments and tendons, the more we discover that they are not receptive to this type of therapy since they are non-contractile tissues. Instead, we want to restore the muscle and postural imbalances that are causing it to be stressed in the first place. So, yes, use a foam roller or massage stick, but on the surrounding muscles, not the IT band. Book a massage treatment with Kristen or Sarah to ensure the right muscles are being worked and for some assisted stretching!
In summary, why treat the symptom when you can treat the cause? This blog is not meant to take the place of seeking medical treatment. Call OMBE and begin a treatment plan that is right for you. We’ll get you back in balance and ready to hit the pavement...pain-free!