So what causes IT Band Syndrome?
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 - known as "knee adduction". 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.
In fact, research shows that "lateral knee pain in runners localized to the distal iliotibial band is associated with increased knee adduction." (Resource: https://www.ncbi.nlm.nih.gov/pubmed/29705166) Therefore, the physical therapy fix for this is to reduce this knee adduction tendency and normalize it closer to a more neutral stance position by strengthening gluteal muscles.
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.
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