IT Band Syndrome
Thursday, March 1, 2018
Spring is just around the corner and recreational runners everywhere are looking forward to tightening those laces, hopping off the treadmill and going for a run outside. Many runners will begin to log more miles each week while preparing for community fun runs or even the Lincoln Marathon. Running more miles runs up our risk of repetitive use injuries as well. One of the most common injuries that runners develop is “IT Band Syndrome”. One study reported that IT band Syndrome accounts for up to 12% of all running injuries.
So just what is the “IT Band”? And what is “IT Band Syndrome”?
The “IT” stands for Iliotibial band, which is a taut thick band of connective tissue that runs along the side of the thigh from the pelvis to the knee. It originates on the muscles of the Tensor Fascia Latae and the Gluteus Maximus as well as a portion of the pelvic bone. As it extends from the pelvis on its path down the outer thigh it passes over the hip bone (the greater trochanter of the hip) and then continues toward the knee it passes over the outside edge of the thigh (femur) bone, called the lateral femoral condyle. A fluid filled sack, called a bursa, is present to decrease the amount of friction between the IT Band and the bone at the outer edge of the knee and hip.
IT band syndrome is the result of excessive friction between the bone and the IT Band at the outside part of the knee. Irritation and inflammation arise from this friction when the runner’s knee repetitively bends and straightens during running. Excessive friction between these structures produces pain and inflammation and is not normal. Runners who experience IT Band Syndrome may experience pain and swelling along the outside of the knee or hip, and/or a “snapping” sensation on the outside edge of the hip or knee.
There are many causes that may lead to this excessive pressure. However, I firmly believe that in most cases a true physiologically “tight” IT Band is NOT one of those causes. Recent cadaveric studies suggest that the IT band cannot be stretched readily and that clinical tests designed to assess the “tightness” of the IT band are ineffective. That being said I do believe that the IT band can present as if it is “tight” as result of an “overactive” Tensor Fascia Latae muscle, from which it originates on the outside front edge of the pelvis. Part of the function of the Tensor Fascia Latae is to work together with the hip abductor muscles to move the leg, and control the position of the pelvis and leg during weight bearing activities.
So why would our Tensor Fascia Latae muscle be “overactive”? An overactive Tensor Fascia Latae is the result of compensation for week hip abductor muscles, or poor neuromuscular control and lower extremity biomechanics. It is trying its best to help provide stability to the pelvis and leg, and when attempting to do so, pulls on the IT Band and makes it “tighten up”, which results in increased pressure on the bursa and tissues beneath the IT band at the outside edge of the knee and hip. Therefore, it is important to have a strong core and hip muscles to stabilize the hip and knee joints during running. It is equally important to teach your body how to work in a coordinated controlled manner to minimize the physical stresses that can occur during running.
Our Physical Therapists are trained to work with you to determine an effective course of treatment designed to address your pain, or minimize the risk of developing a running injury. If you have any questions regarding your running pain, please contact us to speak with a member of our staff.
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