IT Band

Welcome to SelfCare Saturday where we practice SelfLove through SelfCare!

This week I’m talking about IT Band Syndrome. Please avoid self diagnosis, if you think you might have IT Band Syndrome then go see someone (massage therapist, physiotherapist, osteopath) who can help you assess and find the root of the problem. For general information see the link below:

How to tell the difference between the two most common knee pain problems in runners, IT band syndrome and patellofemoral pain…

VERY IMPORTANT! 

Just like any injury, when it’s acute… STOP! I’m sorry to be the one to tell you that you can’t run through it! This means rest and ice until you’re ready to move on to some remedial activities.

Once you are out of the acute stage you are ready to move on to some remedial treatment…

POSSIBLE INTRINSIC FACTORS

1. Tightness in the iliotibial band.
2. Myofascial restrictions in the hip and thigh musculature, which will increase tension on the band.
3. Weakness in hip abductors, (common in distance runners).
4. Weakness or poor control of knee muscles, especially the quads.
5. Dominance of anterior hip muscles, (TFL) over posterior hip muscles, (gluts).
6. Excessively flat feet or high arches.
7. Bow legs or knock-knees.
8. Leg length inequality.
9. Limited ankle range of motion.

POSSIBLE EXTRINSIC FACTORS

1. Training errors e.g. Excessive mileage
Sudden increase in mileage
Sudden increase in intensity of training
Too much hill work
Running on crowned roads2. Over striding
3. Worn out running shoes
4. Failing to warm up or cool down properlyAll of the extrinsic and most of the intrinsic contributors can be addressed to minimize stress on the ITB and reduce the risk of injury.

CHECKLIST FOR THE PREVENTION OF ITBS

1. Change running shoes every 300 to 500 miles, or every 3 to 4 months, when they have lost approximately 40 to 60 percent of their shock absorbing abilities. High mileage runners should have two pairs of shoes to alternate between, to allow 24 hours for the shock absorbing material to return to its optimal form. Do not underestimate the importance of good shoes in the prevention of many types of injuries. It’s worth the cost in the long run.
2. Always slowly increase running mileage and if adding hills, do so gradually. Downhill running especially increases friction on the ITB as well as fatiguing the quadriceps, which are the main stabilizers of the knee. If too tired they will not be able to control the knee position and this may lead to unwanted stress and injury.
3. Avoid training on uneven surfaces, as the down leg may be predisposed to ITBS.
4. Always keep the knees warm. ITB seems to react adversely to cold, so cover up your knees when running outdoors if it’s below 60 degrees.
5. After a run, cool down and stretch; ice if necessary.

TREATMENT AND REHABILITATION

Rehabilitation is aimed at reducing inflammation, restoring flexibility of the muscles and joints affecting the ITB and improving overall control, muscle imbalance and alignment of the lower extremity and foot.

ACUTE PHASE

• Activity modification is essential to reduce friction to the band. Try cross training into other aerobic activities that don’t cause pain during or after activity. Pool running may work because it is non-weight bearing. This will take tension off the band. Swimming with a pool buoy between the legs will reduce any mechanical irritation completely and may be best for the first few days.
• The elliptical machine and cycling may be attempted, as the biomechanics are different from running even though the knee is bending and straightening, but if pain does occur discontinue.
• Everyone is different, depending on the level and exact mode of inflammation, tolerance to cross training will vary. In this author’s opinion, if it doesn’t hurt before or after activity, then it should be OK to continue. Sometimes “a change is as good as a rest.”
• Ice! Ice! Ice! Ice applied locally until the area feels numb should be carried out at least 4 times a day. Ice will help to reduce inflammation and will continue to be beneficial throughout the course of treatment.
• Sleep with a pillow between the knees to decrease tension on the ITB.

SUB-ACUTE & GETTING BACK IN ACTION PHASES

See your Healthcare provider to help you through some remedial activities, including trigger point therapy, facilitated stretching, and mobility and stability exercises for the hip, knee, and ankle. You can include the video above in these phases.