The Run Down - The RunVermont Blog

You asked, we answered: IT Band issues

by leandre on May 10, 2013 · 2 comments

in Ask the Physical Therapist,Notes from the Station

Not too long ago we asked our readers about the topics they would like to read more about on The RunDown. We compiled the list then asked RunVermont staff and members of our running community to assist with the writing. Thanks to Christine Hagan of Green Mountain Rehab and Sports Medicine for this advice:

The iliotibial band is a thick band of fascia that originates on the ilium (pelvis), runs down the outside of the thigh, and inserts on the tibia (lower leg), with extensions to the patella (knee cap) and hamstring tendon.  It functions to provide stability for the knee during weight bearing activities, especially during running.  Iliotibial band (friction) syndrome is a common injury among endurance athletes that results from irritation/inflammation and thickening of the band as it crosses over the knee joint (and rubs along the lateral epicondyle of the femur).  Due to the attachments to the knee cap, the IT Band can also contribute to patellofemoral pain syndrome (i.e. abnormal tracking of the knee cap).

Ok, enough PT jargon … In basic terms, both conditions most commonly result in lateral knee pain.  The pain related to IT Band dysfunction is usually worse with stairs, moving after prolonged sitting, and during/after running (also biking and swimming the breaststroke).  Other symptoms include swelling, and a popping or snapping sensation on the outside of the knee or around the knee cap when bending/straightening the knee.

Although the symptoms of these conditions are similar for most people, the causes can be quite different.  Therefore, the treatment will vary for each individual.  For example, one runner may have weak hip abductor muscles leading to abnormal stride mechanics (knee collapsing inward), causing the IT Band to be pulled abnormally across the knee.  Another runner may be an overpronator (arch collapsing) which can cause the same abnormal stride mechanics, but the treatment would be a lot different.  For some people, the onset may be related to a training error – increasing mileage too quickly, adding in too many hills, or training through fatigue or other injuries.

Most people have a combination of impairments contributing to their pain.  Common findings include: weakness of the gluts, tightness/decreased mobility of the IT Band and quads (especially lateral quads), poor functional quad and hip control, overpronation, core/pelvic weakness.

This injury can be very painful and most often gets worse with continued running – to the point where it will be painful with walking.  It is most effectively treated if it is caught early.  And, the absolute most effective treatment is prevention!  Since it is such a common injury among runners, everyone should take preventative action.  Here are some recommendations for prevention:

-Foam rolling the IT Band, lateral quads and lateral hamstrings

-Strengthening the gluts, pelvic and core muscles (functional exercises that mimic the running stride)

-Stretching the quads and hips (pigeon pose is a great one)

-Making sure you have the appropriate shoe-wear for your foot type and that they aren’t too old

-Progress training gradually (this includes pace, distance and terrain)

-Make yoga a regular part of the weekly routine

-Seeking out a deep tissue massage for the IT Band and other tight leg/hip muscles

-Trial Trigger Point Dry Needling to release tightness of the IT Band and other tight leg/hip muscles

If you start to develop lateral knee pain despite these efforts, don’t delay – seek out treatment with a local PT!  It is much easier to treat in the early stages.

{ 2 comments… read them below or add one }

1 blog March 26, 2014 at 7:22 am

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2 Paige April 7, 2014 at 9:58 am

My doctor recommended a golf ball muscle roller for my ITBS, surprisingly worked very well, check it out!! http://zzathletics.com/Golf-Ball-Muscle-Roller-Massager-GBMR1.htm

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