Illiotibial band syndrome (ITBS) is one of the most common running injuries today–and also one of the least understood.
While most physical therapists and clinicians who have experience treating running injuries understand how to treat IT band syndrome, the average runner doesn’t have a clue. Common do-it-yourself treatments include:
- Icing the side of the knee
- Stretching the IT band from the hip (the IT band has the consistency of a truck tire and is supposed to be tight)
- Foam rolling the IT band (ouch!)
- Complete rest
But ask most runners who have tried these treatments and they’ll say that as soon as they started running again, their IT band syndrome flared back up. It’s a stubborn injury and doesn’t respond to the treatments discussed above. IT band syndrome is not an injury of inflammation (so icing won’t help) or tight musculature (so foam rolling the band itself or stretching won’t help).
So, what does work? Let’s discuss the structure of the injury first to understand the true nature of IT band syndrome.
What Causes IT Band Syndrome?
The Illiotibial band is a thick piece of connective tissue that runs parallel to the femur from the hip to the knee. It attaches along the gluteus maximus and tensor fasciae latae on the side of the hip and connects on the lateral side of the tibia. One of its major functions is to stabilize the knee while running.
IT band syndrome is diagnosed when pain presents at the insertion point of the IT band on the outside of the knee, typically caused by compression due to an abnormal movement pattern of the femur.
So what causes your femur to move abnormally? Usually, a weak butt. Your gluteus maximus and medius are the two major muscles that control the position of the pelvis and overall stability of the leg during the running stride. Weak hips also contribute to the pelvis “dropping” down on the non-stance leg.
All this talk about the position of the pelvis is critical. Because when your pelvis moves into an unfavorable position, the IT band pulls away from the knee.
ITBS is a problem with excessive, abnormal movement of the pelvis that must be controlled.
And how do you control excessive movement? By strengthening your supporting musculature to handle the impact forces and torque of running. While strength workouts are incredibly helpful, they’re often the strategy that most often gets skipped.