What is IT Band Syndrome?

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What is IT Band Syndrome?

If you're a fitness enthusiast or a runner, there is a good chance you've heard of IT Band Syndrome, or at least of the IT Band. But what is the IT Band? What does it do and why does it become painful? And how can you get rid of pain here?





The IT (Iliotibial) Band is a thick band of fascia that begins at the outside of the hip and extends down the outside of the thigh to attach just below the knee joint. Its main role is to provide stability on the outer line of the thigh during the gait cycle, such as during walking or running. It also adds some stability to the outside of the knee. Proximally near the hip, the IT band originates from a muscle called Tensor Fascia Latae (TFL), and distally attaches onto Gerdy's Tubercle (aka a bony bump) just distal to the knee joint. It also has many connections to the Vastus Lateralis muscle (one of our quadriceps muscles) anteriorly, and the hamstring muscles posteriorly. Because it is fascia (aka thick and fibrous tissue, closer to a tendon) it doesn't contract per se, but contraction of the TFL can cause the IT band to become more taught thus giving the leg muscles more support (ie it makes sure the quad muscles and hamstring muscles are well supported and able to contract efficiently like during running).


The most common site of pain with IT Band Syndrome is pain on the outside of the knee, however in more severe cases you can notice pain the entire outside of the thigh. Most commonly I find the symptoms appear in the IT band, however the cause is often due to a tight and weak gluteus medius that isn't able to support the pelvis while walking and running. When this happens the IT band and TFL try to take over to support the pelvis, but they really aren't designed to do this job, so they fail relatively easily and eventually become painful themselves.



The diagram on the left shows a strong, healthy gluteus medius, that is able to keep the pelvis horizontal during walking or running. On the right, the right gluteus medius is weak and unable keep the hips stable during the gait cycle. This can in turn lead to developing IT Band Syndrome


Signs/Symptoms of IT Band Syndrome:

-pain, swelling, or inflammation on the outside of the knee

-Feeling a click, snap, or pop as you walk or run on the outside of the knee

-Pain on the outside of the thigh

-Pain on the outside of the thigh or outside of the knee while going down stairs (or running down hill)

-Pain that worsens in these above mentioned areas during a run (ie the longer you run the worse it gets)


Treatment for IT Band Syndrome:

-Active Release Technique to affected muscles (this typically includes the outside hip muscles and quads, while typically avoiding the IT band itself)

-Self stretching of affected areas

-Rest

-Ice to affected areas

-Strengthening of the lateral hip musculature (gluteus medius)


Typically with appropriate medical care and home care this can resolve quite seamlessly without need for further intervention. Always consult your health care provider to ensure you receive a proper diagnosis for your condition.


What about Foam Rolling the IT Band?

Quite frankly, when the IT band is sore rolling the IT band just hurts, and I have found that stretching and strengthening the lateral hip musculature (gluteus medius) leads to better resolution of symptoms, while minimizing agony rolling on the foam roller! Stay tuned for my next article which will highlight some of my favourite stretches and strengthening exercises for a sore IT band.


Dr. Elaine Screaton (DC, BSc) is a Chiropractor in NW Calgary currently practicing at Synergea Family Health Centre in Calgary, AB.

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