If you’ve ever laced up your running shoes and found yourself battling the nagging discomfort of IT band pain, (often referred to as IT band syndrome) you’re not alone. In addition, many runners with knee and/or hip pain do not even know that the IT band could be responsible! This blog is your personal guide to understanding and conquering the challenges of IT band syndrome, inspired by the recent journal article, “The Iliotibial Band: A Complex Structure with Versatile Functions.”
Anchorage, Alaska, with its rugged terrains and breathtaking scenery, is a paradise for runners. However, as any seasoned runner in the Last Frontier knows, IT band issues can be as chilling as an Arctic breeze. That’s why we’re here to delve into the multifaceted world of the IT band, exploring its vital functions, the culprits behind IT band pain, and, most importantly, effective treatments tailored to our Alaskan running community.
What is the IT Band?
The Iliotibial Band, Or IT Band is composed of both superficial and deep layers of connective tissue and run along the outer thigh, bridging from the hip to the knee. It is a thickening of the fascia along the side of our legs that develops after we begin walking as children. This large, seemingly simple band of tissue plays multifaceted roles in the human body. Many of which we will discuss in this blog.
Functions of the Iliotibial Band
Understanding the roles of the IT band, it is easy to pinpoint where issues are likely to arise, especially for runners! The IT band plays 2 main roles in the human body:
- Stabilization: The ITB contributes significantly to knee joint stabilization during various activities such as walking, running, and cycling. It acts as a tension band, distributing forces and preventing excessive lateral movement of the knee.
- Shock Absorption: The ITB is a significant shock absorber, mitigating the impact forces experienced during activities like running. This vital function reduces stress on the knee joint and its surrounding structures. It also returns these forces to the ground when you push off, helping propel you forward.
Suspected Causes of IT band pain
IT band pain falls squarely within what one might term an “overuse” type injury. Because the IT band plays such an important role in shock absorption it can occasionally become a source of discomfort and pain when training increases. IT band pain, historically called IT band syndrome is characterized by pain on the outer side of the knee. Previously it was thought to be related to friction, but more recent research seems to indicate compression is a more likely cause. Similar to other tendon issues, repetitive loading (in this case compression) that occurs with running likely exceeds the IT band’s tolerance to load and causes it to become painful.
Effective Treatments for IT Band Pain
- Physical Therapy and Targeted Strengthening: Hip (and glute!) strength is historically blamed for issues with the IT band. Although this is important to address, addressing muscle groups such as the quad and hamstring is equally important. Likewise, working to achieve heavier loads over time and lower rep ranges is likely to result in larger adaptations to the IT band than lighter loads.
- Biomechanical Assessment and Gait Analysis: A nuanced approach to treating ITB issues involves a comprehensive biomechanical assessment and gait analysis. Studies, although limited in quality, have demonstrated patterns that seem to load the IT band to a greater extent. Just a few examples of gait patterns that load the IT band include, hip drop, leg adduction (or cross-over), and over-striding. Learning how to reduce the load that running places on the IT band can help to reduce pain and keep you training for your next event. Considering the terrain, cadence, and biomechanical factors with running can all help you to minimize pain with training.
- Modalities: IT band syndrome can cause a cascade of issues for the runner. Not only can they experience knee pain, but many also present hip issues, TFL (tensor fascia latte) and glute tightness, and lower back pain, just to name a few. There may be a place for modalities like extracorporeal shockwave therapy (ESWT), deep tissue massage, trigger point dry needling, BFR, and more. Modalities used in physical therapy at Runners’ Edge Alaska are always tailored to the unique needs of the runner.
I’ve put together some of my favorite tips to manage and prevent IT band pain on our Instagram Page. Check it out HERE!
The world of the internet sells a lot of “quick fixes” for IT band pain. Beware of these common misconceptions:
- Foam Rolling– Foam rolling may feel nice, but it will not be very helpful in eliminating your IT band pain. While it might provide some temporary changes to pain, there is no clear evidence that it has a long-term effect on IT band pain or recovery.
- Stretching– If you are ever told to stretch your IT band to fix your pain, think again! While many treatment strategies have previously included a lot of stretching, a 2008 study shows that it takes over 2,000 lbs of force to deform the IT band by 1%. Stretching is unlikely to result in any structural adaptations to the IT band given this fact and may not be very helpful in rehabilitation.
In conclusion, the iliotibial band is a multifaceted structure that demands a comprehensive approach to address IT band pain effectively. Our team at Runner’s Edge Alaska, a sports physical therapy clinic in Anchorage, Alaska, specializes in aiding injured runners in their journey back to the track and trail. We advocate for a holistic strategy that integrates physical therapy, targeted strengthening, biomechanical assessment, and tailored modalities and training adjustments to alleviate IT band discomfort and restore optimal function.
Our running specialist PTs intimately understand the unique challenges posed by our environment and will not only help you relieve your IT band discomfort but also prepare you for lacing up to cruise through Anchorage’s trails and crush your next race! Run on!
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