One of the great perks of having a blog is the ability to write and do in-depth research about runners’ issues that are either affecting me (or have affected me), or have the most potential to help the greatest number of runners.
It’s really awesome.
Today I am most certainly delving deep into an issue that has affected me in the past, and is also one of the most common issues encountered by runners from all training backgrounds and training levels.
Enter The IT Band Syndrome
In fact, chances that it’s affecting you at present, or has in the past; or maybe you are at risk, and you don’t even know about it.
However, before I delve deep into some of the treatment and prevention strategies for this incapacitating condition, let’s first take a quick look at the medical definition of ITBS and some of the main factors that cause it.
What Is IT Band Syndrome
Iliotibial band syndrome is an overuse injury of connective tissues of the outer thigh and knee, and it’s one of the most common injuries experienced by runners from all training backgrounds and fitness levels.
But what is the IT band?
The Iliotibial Band Defined
The Iliotibial band is the lower portion of the tensor fasciae latae—or TFL for short.
The IT band is not a muscle. Instead, it’s a thick tendon band of fibers that begins on the iliac crest—the border of the most important bone in the pelvis—on the outside of the hip. This band has attachments to its origin from three different muscles: the gluteus medius, gluteus minimus, and vastus lateralis.
Next, the IT band runs down the outside of the thigh, then crosses the knee joints and inserts along the lateral segment of the kneecap—or what’s known as the patella—and into the tibia, the major bone of the lower leg.
This tendon has one primary function— ensuring lateral stability in lower extremity—especially of the knee as it flexes and extends through its range of motion.
In other words, the IT band coordinates muscle function and stabilizes the knee during foot strike, when running for instance.
See the image
ITBS: The Injury Process
Iliotibial band syndrome occurs as a result of the friction of tight IT band rubbing at the knee and/hip. When the ITB comes near the knee, it becomes narrow, and rubbing can occur between the band and the bone, leading to debilitating pain.
Tightness and weak muscles—especially the glutes and hip muscles—set the stage for ITBS. Muscle weakness (and imbalances) and the high impact and repetitive nature of running increases strain and stress on the IT band, leading to pain and injury.
How to Spot the Problem – The Signs of ITBS
Basically, ITBS is pain and tenderness along the outer side of the knee where the bone hits above the joint, often coming with a clicking sensation.
This clicking sensation is the by-product of the Iliotibial band tightening and cracking across the knee joint when running.
The most common symptom of Iliotibial band syndrome is swelling coupled with a sharp burning pain on the outside of the knee. This is why many runners have often mistaken it for the infamous Runners Knee (and other knee injuries).
But that’s not true. ITBS is different than the classically notorious runners’ knee.
Therefore, keep in mind that Iliotibial band syndrome is not a KNEE INJURY—even if you had pain and significant swelling on the outside of the knee.
For an accurate ITBS self-diagnosis, bend your knee at a 45-degree angle. If you feel pain on the outside of the knee, then you might be having IT band problems.
You may also have ITBS when you start feeling pain and tenderness on the lateral side of the hip or knee, after a mile or two of running—That’s typically after around 5 to 10 minutes of running.
The pain is often worse when running up or down hills. And as soon as you switch to walking, the pain goes away.
It Takes Time
Like most common overuse running injuries, IT band syndrome takes a gradual process to become debilitating. It does not happen overnight.
So it’s gradual, beginning with stiffness and typically moving to the point when the pain is no longer tolerable, forcing the runner to stop from any further training.
Note: Keep in mind that this is a very debilitating injury. It can sideline you for weeks, or even longer—especially if you don’t know how to tackle it right and relieve the pain.
Causes of Iliotibial Band Syndrome
Along with the biomechanical causes, mainly muscle imbalances in the lower body—especially weak glutes and hamstrings—and a lack of flexibility in the hamstrings and hip flexors, ITBS can develop due to other reasons.
In fact, ITBS happens as a result of the culmination of a multitude of causes.
Here are a few:
- Running in the improper shoes.
- Running on banked on improper surfaces—especially banked surfaces.
- Doing too much too soon.
- Poor ankle range of motion
- Too much downhill running.
There is a solution you know
This is one of the most common and widespread overuse injuries among runners of all ages and training backgrounds. That’s good news as there are plenty of proved ways that can help you relieve the pain.
How to Treat Iliotibial Band Syndrome
When it comes to preventing this painful injury, there are some things you can do.
Note: Just keep in mind that to prevent IT band syndrome for the long haul, you will need to opt for a proactive and extensive injury treatment—especially if you are in advanced stages of the injury, and too much damage has been done.
Here is what you need to do to get back on track—no pun intended 😉
Your first line of defense against most running injuries is the widely known R.I.C.E strategy.
So at any sign of trouble, back off from running, ice the painful area two to three times a day, and apply compression using bandages or stockade to reduce inflammation and pain.
You can also use anti-inflammatory drugs such as ibuprofen to soothe the pain but take them sparingly and only in cases of extreme pain.
Let the injured area recover at its own rate.
In most cases, running will only exacerbate the symptoms of an overuse running injury—this is particularly the case when it comes to ITBS.
In fact, it’s really simple and straightforward—if running hurts you, don’t do it.
How much rest you will need depends, mostly, on the severity of the injury.
But as a general guideline, if you spot IT band syndrome in its early stages, a few days off will do the trick. However, if you have been running with ITBS for quite sometimes, then you will definitely need more rest, weeks even months off the running field.
But that’ doesn’t mean that you will have to sit on your butt and do nothing. You can always cross-train and opt for activities that don’t put too much stress on the injured area.
Anything low impact will do.
I highly recommend that you do a regular yoga practice (that’s strength and stretch work in one mix), and regular strength exercise as well (add the strength moves below to your resistance training). These practices will not only help you prevent IT band syndrome, but also fix the muscle imbalances, which is the leading cause of most running injuries.
The Proactive Approach for Preventing IT Band Syndrome
The deal with IT band syndrome—and the majority of other overuse running injuries—that the problem won’t necessarily be gone forever by taking a couple of weeks of rest.
According to my own experience, and the research conducted on this subject, this problem will find its way back to your running program—even after taking three months, or even a year off.
This, most likely, because most overuse running injuries are the result of muscle imbalances, and when a muscle imbalance is left unchecked, it tends to stay so, causing all sorts of biomechanical problems.
That’s why your IT band might end up inflamed and sore after a couple of weeks of training post-recovery.
Therefore, if you are serious about warding off this condition for the long haul, you need to work on fixing the muscles imbalances that caused the injury in the first place—mainly weakness in the glutes and hips.
- Strengthen your Hips and Glutes
As I stated earlier, weak glute and hip muscles have a say in ITBS development. So it’s crucial to strengthen these regions.
Here are five strength exercises that target these areas so you can back on track in no time:
Lateral Leg Raises
Lying Glute Stretch
These simple exercises can help you strengthen the body’s largest and maybe the most powerful muscle group: the glutes.
This also adds strength to your hamstrings. You can add these exercises to any workout, or they can be used as workout routine on their own—in fact, this is mandatory if you have the condition, and you are serious about returning to running as soon as you can.
Along with these 5 exercises, I highly recommend that you do a regular core training workout. Not just crunches and sit-ups, but a well-rounded and intense routine.
Here are two routines to consider:
- Roll the Band
Foam rolling—which is a self-massage technique geared toward undoing “fascia knots”—is the best tool for stretching the IT band, as well as preventing and relieving ITBS pain.
The pressure applied by a foam roller can help you loosen up and the fascia and tendon along the IT band, which promotes mobility and relieves pain.
Here is how
Lie on your side with the roller under your leg. Then, while using your own bodyweight for pressure, roll your IT band from its origins in the hips, down to the knee. Stop at any areas that feel unusually tender or tense and release it slowly. Just be sure never to roll a joint.
Do this simple ITB foam rolling exercise at least once a day, and make it a part of your pre-run warm-up ritual if you can.
Here is the foam rolling routine you need for better and injury-free running.
- Returning to Running
In most cases, ITBS stems from biomechanical problems.
Therefore, your ability to go back to your former running glory is dependent on your progress in glute and hip strength and mobility. The sooner you fix the muscle imbalances that lie at the core of the issue, the smoother and pain-free your comeback to running will be.
If you caught ITBS before it gets serious, it would only take you a few days to a few weeks off the running train for the inflammation on the outside of the knee to settle. Icing the injured area a couple of times a day can speed up your recovery.
It will only take you a month to two months of regular strength training to undo the damage and completely recover. So don’t give up too soon. Just be patient and give it time. The more you work on the muscle, the stronger it will get, eventually.
- Practice Proper Running Habits
Along with cross-training, foam rolling and strength training, make sure that you are running right as well.
So if you are serious about preventing overuse running injuries—not just ITBS—then be sure to develop these healthy running habits:
- Run in the proper running shoes.
- When it comes to adding mileage, slow and gradual is the way to go.
- Do your bulk of running on proper surfaces. Steer clear of hard, concrete and banked surfaces as much as you can.
- Work on developing proper form.
- Keep listening to your body and re-adjust your training approach accordingly. And never ignore pain—pain it’s usually a sign of something going wrong—so keep an eye on it and never shun it.
Here you have it.
I think that’s it on how to treat and prevent IT band syndrome.
Please feel free to leave your comments and questions below.
Thank you for reading my post
Featured Image Credit – Micolomansana through Flickr.