IT Band Syndrome
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Have you ever experienced pain on the outside of your knee after running? It can be mild which will make your runs difficult or it can be severe which can seriously limit your ability to run at all.
This may well be IT Band Syndrome. The term may sound scary but it's incredibly common. It can however be treated and indeed prevented quite easily if you have a little knowledge of what is actually going on. |
The Iliotibial Band (IT Band) is a thick, fibrous piece of connective tissue that runs from your hip, down the outside of your thigh, across the knee joint and attaches into the tibia bone in the lower leg. It's job is essentially to assist with stability of the knee joint during high stress knee actions such as running.
It is important for the IT Band to move around freely at the knee joint through different stages of flexion and extension but occasionally it can become over restricted which will cause friction on the outside of the knee and therefore inflammation and pain.
But what causes this restriction?
But what causes this restriction?
Before we talk about possible causes I need to get a point across and bust an urban myth that you may have heard. The IT Band is not a muscle and is therefore not contractile. You cannot stretch it to remove tension any more than you can foam roll it. You may have seen people laid out over their foam roller and doing big sweeps right down the outside of the thigh as they tell you that they are foam rolling their IT Band. This is an entirely pointless exercise and simply gives you pain for no reason. In order to free up the IT Band we need to understand it's relationship with neighbouring muscles.
There are a number of muscles that feed directly into the IT Band and if these become tight due to weakness or overuse then it will have a direct impact on the IT Band itself. The main likely suspects are the Tensor Fascia Latae (TFL), the Gluteus Maximus and the Vastus Lateralis.
Tensor Fascia Latae (TFL)
The job of the TFL is to assist the Glute Medius muscle in abducting the thigh as well as rotating it. It can also be called upon to assist in hip flexion although this is not it's primary role. It is quite a small muscle and is located at the top of the thigh and slightly towards the outside, imagine your trouser pocket area. If you look at the diagram above, you will see that it feeds directly into the IT Band and therefore if the TFL becomes tight, the IT Band suffers. A tight TFL is very common in many runners due to the fact that it's a small muscle but becomes very tired very easily due to the repetitive nature of running and especially if you have muscle weaknesses in other areas such as the main hip flexors. It can also become short and tight by excessive sitting.
Vastus Lateralis
The Vastus Lateralis is the largest of the Quadraceps (quads or thigh muscle) and is used primarily to extend the lower leg by way of knee extension. It doesn't have a direct feed in point to the IT Band like the TFL but it is the immediate neighbour and can therefore cause adhesion. Obviously, the act of running is going to cause huge workload in the Vastus Lateralis and therefore tightness in this muscle is inevitable and it follows that it can have a negative effect on the IT Band.
Gluteus Maximus
The Glute Max is the powerhouse of running. It is regarded as one of the strongest muscles in the body and is the main extensor of the hip joint. This muscle, like the TFL, has a direct feed in to the top of the IT Band. It goes without saying that the Glute Max is going to become tired and tight after a good run and if not stretched out then this tension will go directly into the IT Band.
So now that we've identified the main players in introducing tension into the IT Band, what can we do with this information?
The good news is that, to begin with, all you need is some floor space and a Foam Roller.
We need to stretch and foam roll these muscles to remove any tension and return to full length.
The good news is that, to begin with, all you need is some floor space and a Foam Roller.
We need to stretch and foam roll these muscles to remove any tension and return to full length.
The remedial actions shown below are for general, self help and maintenance only. If your problem doesn't ease or gets worse, cease these actions and consult your GP or Qualified Physiotherapist.
Stretching the TFL
TFL Stretch
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To stretch the Tensor Fascia Latae, stand beside a wall and place your hand against it for stability. The TFL to be stretched is the one nearest the wall.
Cross the other leg in front for stability and lean the TFL to be stretched towards the wall until you feel a stretch in in the upper and outer thigh area, around the pocket area. Hold the stretch for 15 seconds for maintenance stretch Hold for 30 to 45 seconds for developmental stretch. Repeat on both TFLs |
Stretching the Glute Max
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Sit in a comfortable position and cross your left foot over to the outside of your right leg and higher than the knee.
With your right arm, grab the knee and pull it into your right upper chest until you feel the stretch in your buttock area. You can increase the stretch by twisting your torso to the left as you do this. Hold the stretch for 15 seconds for maintenance stretch Hold for 30 to 45 seconds for developmental stretch. Repeat on both Glutes. |
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Sit on the floor with your knees bent in a figure 4 shape. Twist your torso so the your chest is facing the knee of the leg your going to work on.
Place your hands on the floor either side of your knee and keeping your back straight, tip forward towards your knee until you feel a stretch in the buttock area. Hold the stretch for 15 seconds for maintenance stretch Hold for 30 to 45 seconds for developmental stretch. Repeat on both Glutes. |
Stretching the Vastus Lateralis (Quads)
Quads Stretch
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Standing with an upright posture, take hold of your left foot in the upper laces part of the shoe and pull it towards your butt.
Ensure your knees remain in line with each other and an upright posture is maintained, you may hold onto a wall for stability. Pull towards your butt until you feel a stretch in your quads. Hold the stretch for 15 seconds for maintenance stretch Hold for 30 to 45 seconds for developmental stretch. Repeat on both Quads. |
Quads Stretch
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This is a deep stretch for those where the standing stretch doesn't go deep enough.
Position yourself on one knee with your left foot against a wall or sofa and leaning forward. As you lift upright you will introduce the stretch into your left quads. Once upright, push your hips forward for a deep stretch into the quads. Hold the stretch for 15 seconds for maintenance stretch Hold for 30 to 45 seconds for developmental stretch. Repeat on both Quads. |
Foam Rolling the TFL
Foam Roll The TFL
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Start by lying on your foam roller with your left hips stacked and upright. Then cross your upper leg over and forward and place your foot on the floor. Tip your pelvis slightly forward until your pocket area is now feeling the pressure from the foam roller.
Begin moving up and down an few inches and hunting around for tender spots. Tip the pelvis forwards and back also to cover the whole TFL area. When you find a tender spot, hold still on it and press in firmly, remembering to keep deep breathing as you do so. After a few moments the tenderness should ease and you can carry on rolling. Do this for 2 to 3 mins and repeat on the other side. |
Foam Rolling the Glute Max
Foam Roll The Glute Max
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Sit on your foam roller and then lean towards the left side until that is the only buttock in contact with it. Cross your left leg over your right knee.
Now begin rolling up and down between the waist line and the very top of the thigh as well as tipping your pelvis left and right to cover the whole buttock area. When you find a tender spot, hold still on it and press in firmly, remembering to keep deep breathing as you do so. After a few moments the tenderness should ease and you can carry on rolling. Do this for 2 to 3 mins and repeat on the other side. |
Foam Roll the Quads
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Position your self face down, supported by your hands and straight arms and place the roller under your left thigh.
With your knee bent to 90 degrees tip rotate your thigh outwards so that it is the outer part of the quads that is in contact with the roller and begin rolling up and down looking for tender spots. When you find a tender spot, hold still on it and press in firmly, remembering to keep deep breathing as you do so. After a few moments the tenderness should ease and you can carry on rolling. Begin rotating the thigh back towards the centre and then the inner thigh to ensure you cover the whole area of the quads. Repeat on both thighs. |
Prevention
While it's possible that these remedial actions can bring some relief to your pain in the short term, it's quite possible that the problem may return if the underlying cause is not addressed. These muscles became tight for a reason such as,
It is essential that you include an element of strength and conditioning in your weekly training plan. This doesn't necessarily require a gym membership as many exercises can be done with body weight at home.
- Poor running form and technique
- Weak muscles such as glutes, hamstrings, quads
- Misfiring muscles
- Muscular strength imbalances
It is essential that you include an element of strength and conditioning in your weekly training plan. This doesn't necessarily require a gym membership as many exercises can be done with body weight at home.
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