Illiotibial Band Syndrome is one of the most common injuries in athletes and people who have a high training volume. This could include your endurance athletes and those who like to torture themselves with a high volume of squat reps.
It can be painful and sometimes debilitating but most people have no clue how to treat themselves. Before we go into how to fix the issue, lets first go over the anatomy of the IT Band.
The iliotibial band is a thick band of tissue on the lateral part of the upper leg. It runs form the outside of the hip all the way down to the knee. The IT band arises from the tendons of the tensor fasciae latae(TFL) and the gluteus maximus. In then travels down the outside of the thigh across the knee joint and inserts of the out side of the tibia.
The connection between the IT band and the TFL muscle helps in the abduction and flexion of the hip. The interplay between the IT band and the gluteus maximas causes extension so throughout ambulation, force is being transferred down the length of the IT band.
The IT band also helps in maintenance of posture…so basically the IT band is pretty important.
IT Band Syndrome
When most people experience IT Band Syndrome, they complain of lateral knee pain. They may complain of it from the beginning of exercise and persist all the way through.
Someone suffering from IT Band will complain is of discomfort with knee flexion and especially after having their knee bent for a prolonged period of time.
This lateral knee pain is due to the fact that a tout IT band is rubbing over the lateral femoral epicondyle as it moves through knee flexion and back to full extension. The most vulnerable range of motion for this condition is at 30-40 degrees of knee flexion.
Let’s look at the causes of IT Band Syndrome
IT Band Syndrome typically stems from overuse, or doing something repetitively to insult the tissue to cumulatively cause pain.
This explains why typically runners and other endurance athletes suffer from IT Band pain. Rest or decreasing your training volume will be key in decreasing your pain and discomfort.
Tight tissue, and specifically the muscles in the hips and the vastus lateralis (the lateral quad muscle), is often the culprit of IT Band Syndrome. The pain at the knee is just a symptom of a greater issue.
I include the vastus lateralis into this discussion because there is some fascial interplay between this muscle and the IT Band. A tight lateral quad can compound on the tightness of the hip musculature.
Weak Hip Musculature
Studies have shown that weakness of the hip musculature, specifically the hip abductors(gluteus medius) can lead to IT Band issues.
The hip abductors are essential in helping maintain proper posture during the stance phase of the gait cycle. The hip abductors provide stability of the pelvis and eccentrically control femoral adduction and internal rotation.
How to Fix It??
One of the most common mistakes people make is foam rolling the IT Band itself in hopes that they can “break up knots” or muscle adhesions.
Two problems with this belief. First, it would take more force to break up muscle adhesions than a foam roller can provide. The foam roller uses pressure to get the tight muscles to relax and move more freely. Second, the IT Band is not a muscle so using the foam roller on it is not going to cause relaxation. Also, you could possibly cause further irritation of the IT Band.
Instead keep your foam rolling efforts to the glutes, lateral quad, and the TFL. Below are a view videos showing you how to attack each area with a foam roller.
Tensor Fasciae Latae
As you learned before glute weakness can lead to poor control of the lower extremity, often leading to injury down the chain. Here are a couple exercises to specifically strengthen to gluteus medius, one of the muscles responsible for hip abduction. Implement these into your daily warm-up to help activate and strengthen those muscles
Side-Lying Hip Abduction
Mini band shuffles