This month, we are investigating Iliotibial Band Syndrome or more commonly know IT Band Syndrome or ITB Syndrome.

How do you know if you have IT Band Syndrome?

Those with ITB syndrome typically experience pain on the outside of the knee, increased pain with repetitive knee motions, increased pain with walking or running uphill, walking stairs or increased pain at the hip on the outer thigh.

What causes IT Band Syndrome?

The iliotibial band (IT Band or ITB) is an extension of the band (a long tendon) that extends down from a hip muscle called the tensor fascia lata (TFL). Starting at the hip, extending along the side of the thigh and attaching just below the front side of the knee, the ITB has a big impact on both joints.

Those with a lack of flexibility of the TFL/ ITB muscle, bowlegged or people with foot problems may be predisposed to chronic ITB syndrome.

What causes lack of flexibility in the ITB?

There is not a one size fits all answer to this question.  The most common reason for tightness in the ITB is compensation for weak Glute muscles, particularly a muscle called the Gluteus Medius (Glute Med).  The Glute Med can become inactive or weak for a number of reasons; two of the most common are restriction in the hip joint and ankle problems (sprains and weak arches).

When the Glute Med stops firing properly, the TFL will work overtime to pick up the slack and essentially doing a job that is wasn’t designed to do. As with any overused muscle (or person), it becomes irritated. The irritation from repetitive knee flexion and extension causes inflammation and stiffness to occur especially in activities such as running and biking.

How do we treat ITB Syndrome?

Our first job is to get you out of pain and once we accomplished that we need to correct the patterns that brought this problem about.  There are a number of therapies that we utilize to relieve tension in the ITB.  See the following videos for explanations of these therapies.

This video demonstrates using the Fuzion tool on the ITB/TFL

In this video we look at multiple uses of the foam roller including the stretching of the ITB.

This video shows a wall stretch for the TFL/ITB

Our next step is to correct the patterns and muscle imbalances.  There are a number of compensatory patterns that can lead to ITB Syndrome, but we will cover the treatment of the most common which is Glute Med insufficiency.  Glute Med insufficiency will lead to instability in the hips which can be seen below in this video.

When we see hip instability like we do in this video we know that we have Gluteus Medius insufficiency which we can remedy a number of ways.  Our two favorite exercises for this muscle are called “clamshells” and “speed skaters.”   You can see examples of these exercises below.

Because the tight tendon rubs against the thigh bone and pulls tight on the knee, inflammation of this area will lead to pain, which also needs to be addressed.  To reduce the inflammation, it is important to fill your diet with foods that have anti-inflammatory agents.  Here is a recipe that includes a number of anti-inflammatory herbs and spices: Yellow Thai Curry.