Iliotibial band syndrome (ITBS) is a common ailment in runners that is generally thought of as an overuse injury. It affects approximately 7-14% of runners but also distresses cyclists, rowers, and basketball players. Whether an elite athlete or a weekend warrior, ITBS leads to lost pavement time because of hip pain, leg pain, tightness, or a clicking knee. It’s important to reach out to your health care provider as soon as you experience knee pain to prevent further injury so you can keep you doing what you love!
What is Your IT Band?
First and foremost, what is your IT band? In layman’s terms, your IT band is a dense bunch of fibers that span from the outside of your hips, down the thighs, and past the knees. In medical lingo, it’s a very strong combination of tendon and fascia (or connective tissue) that connects to the gluteus maximus and tensor fasciae lata muscles, which follows the length of your leg down past the knee.
What Causes ITBS?
The exact cause of ITBS is not well understood. For decades the condition has been thought of as a repetitive use injury that leads to inflammation and pain. However, recent surgical studies challenge this theory because examination of the area often reveals a lack of an inflammatory response. Other beliefs include abnormal biomechanics of the lower extremities and muscle weakness, especially in the hip abductors.
Possible causes:
- Friction
- Increased internal hip rotation
- Weak hip abductors
ITBS symptoms:
- Pain on the outer side of the knee
- Pain that may worsen with exercise
- Pain up and down your leg
- Feel and hear a clicking or snapping sound outside your hip or knee
Foam Rolling for ITBS
There is some controversy surrounding foam rolling as a treatment for ITBS because it can be difficult to directly access the IT band and because it’s so dense that some believe it’s impossible to manipulate. So, it’s important to mention that foam rolling primarily targets the muscles surrounding the IT band and depending on the technique, sometimes the IT band itself. Releasing the IT band can be a bit tricky because the quadricep covers it and it’s a pretty tough band, but from the right angle, you may be able to get underneath the quadriceps. If you’re a runner or a cyclist, try approaching your IT band from a 45-degree angle, you may find that you are able to get underneath the quadriceps, releasing any adhesions that may have developed over time.
Core muscles to target:
- Gluteal muscles
- Tensor fascia lata
- Quadriceps
Standing ITBS Stretch
To stretch your left IT band, try the standing IT band stretch, also known as the ballerina stretch. Place your left palm against a wall, while standing with your right leg slightly bent and your back left leg crossed behind it. You should be slightly leaning against a wall with your legs parallel and crossed. Try to place more weight on your back leg, (in this case your left leg), and lean your left hip toward the wall. Repeat to stretch your right IT band. *You can also do this stretch with your arms extended above you.
Hip Stability and Strengthening
Though there are debates regarding the exact cause of ITBS, whether it’s due to weak gluteal muscles or from overuse and strain, one thing remains clear—exercise is important to strengthen the surrounding muscles for added stability. The side-lying hip abduction is one of the top exercises for gluteal activation, which is essential in treating ITBS.
Other helpful exercises:
- Hip bridge with resistance band
- Sidestep with resistance band
- Monster walk
Reach Out to Your Healthcare Provider
If you’re a runner, cyclist, rower, or basketball player, as soon as you experience pain on the outer side of your leg or knee; or pain that may worsen with exercise, don’t wait, email or call Cawley PT to address your pain and improve your functional mobility. Hopefully, you’ll be able to get back on the track or on the court and feel good, while doing what you love.
