IT Band pain is a very common ailment we see at Stride Strong.

So what causes this annoying ailment?

When the striding leg lands on the ground during running (or walking), the body weight force vector is on the inside of the leg. This means the moment on the body is to collapse inward. To counteract this moment, the body utilizes its lateral structures (gluteus medius, IT Band, back muscles, sometimes lateral quad and hamstring) to stay upright and stable. Over-utilizing these structures, especially when weak to begin with, could cause compensations that would lead to a thickening of tissue in and around the IT Band. Typically this happens when a runner increases his/her training volume, or runs on an embankment (e.g. shoulder of the road) too much.

What are the symptoms?

Pain on the outside of the knee and/or pain in the lateral thigh, sometimes described as stinging sharp sensation or a dull ache. Pain is typically felt when the foot strikes the ground.

What can be done to treat IT Band Syndrome?

Best home remedies are:

- Ice the knee if it feels inflamed; apply heat to the thigh if it feels tight and stiff (e.g. a warm bath)

- Modify and reduce your running/walking volume

- Use a foam roll to roll out your IT Band from top to bottom, giving closer attention and time to the spots that feel stiffest. Yes, this will feel painful at times.

In the PT clinic:

- Your PT will help guide you through exercises to strengthen those lateral structures of the leg, while also ensuring the IT Band’s mobility along the hamstring and quad interface.

- At Stride Strong we guide our patients through proper gait mechanics and form so they understand and recognize what parts of their biomechanics is making their situation worse.

- In turn, shoe or orthotic recommendations along with stability exercises are prescribed to reduce the pain.

- In the event of a race, taping the knee would help reduce the pain for better performance.

Other therapies for more severe (and rare) cases:

- Patients are referred out to trusted physicians and providers for steroid injections, prolotherapy, or dry-needling.

IT Band Syndrome can take a long time to heal, but release of the tissues does and will happen. Due diligence on exercises and stretches prescribed by your therapist go a long way in treating IT Band pain.

One would think that running, especially long-distance running, would cause an increase in risk for osteoarthritis (OA) later in life. This notion alone is enough to scare a lot of runners from continuing on with their running career. Research shows this is a myth.

MYTH #1: Running causes OA

MYTH #2: The longer distance you run, the more cartilage you will lose

There is indeed a reduction of cartilage volume of about 5-6% after running a 5K. But this volume is regained and returned to pre-run levels within 60 minutes of rest. Research also shows that there is no overall difference in cartilage volume changes between 5K, 10K and 20K runners. Most of this 5-6% volume change is due to dehydration from weight-bearing impact, but levels are regained after rest and rehydration.

What does the Doctor say?

Dr. Ryan Petering, family and sports medicine doctor of OHSU Gabriel Park, states that there is no consistent evidence that weight-bearing sports cause OA. The biggest risk factors for OA are: being inactive, obese, and previous knee pain. Some patients may have higher risks of OA because of previous meniscal tears. In such populations, pivoting sports such as soccer and tennis may increase incidence of OA – so be careful.

What does the Physical Therapists say?

Proper strengthening of surrounding muscles will improve control and attenuation of weight-bearing forces. Knee pain does not necessarily indicate OA in the knee – the pain may be caused by malalignment of the kneecap (common, also known as “patellofemoral pain syndrome”), or tendonitis, or other diagnoses. Proper evaluation by your Stride Strong physical therapist will allow for further insight into the cause of your knee pain.