Your iliotibial (or IT) band travels on the outside of your thigh from your hip to just below your knee. Science speak says, “The IT Band is a lateral thickening of the fascia lata that rises from the tensor fascia latae and gluteus maximus, courses down the side of the leg to lateral femoral condyle and ends at Gerdy’s tubercle at the anterio-lateral tibia.” That’s a mouthful.
Problem is, this band of very strong connective tissue can be a real pain. The orthopedist and physical therapist hosting this session spent a lot of time talking about the pain it causes near the knee, but in the female soccer players I work with it more often causes chronic and much recurring pain near the hip and upper lateral thigh. (in addition to causing pain lateral to the kneecap).
The mechanism for this injury is mechanical stress. That is, this tight band associated with lateral hip musculature is being contracted over and over again trying stabilize the body in upright movement and is irritating the highly innervated fatty and fibrous tissue that lie beneath it. Chronic stress actually changes the nature of this underlying tissue.
Here’s a nice look at the Ober’s test which Physical Therapists use to test for IT Band syndrome: Ober’s Test for IT Band
Management for a tight IT Band includes:
- Stretching and massage. I highly recommend the foam roller to get deep into this tissue.
- Regular strengthening of the hip abductors and hip external rotators
- correcting poor foot mechanics. I like the Power Step shoe insert.
- Correcting running form mechanics. Focus on keeping hips level on foot contact. (video from the rear to see form and correct it by re-training)
- Core strengthening focused on trunk and pelvic stability. Call on this in the landing phase of your stride.
- Correct training errors. Seek out an Exercise Physiologist well-versed in training for running athletes to make sure your mileage, rest, recovery and program are properly designed. Once you are injured, a very gradual return to previous training levels is the only way to avoid a constant return of this injury.
This is what you can take to the field…
Asymmetry and imbalance are our enemies but can be our friends. The body is designed with “2 sides” for a reason. So we can compare one side to the other! Asymmetry predicts injury risk. (more on later posts)
Do this simple test regularly. Lie on your back with both legs straight. Loop a rope or resistance band around your right foot. Leaving the left leg on the ground, holding both ends of the band, use it to raise the right leg by flexing at the hip. Keep your knee straight. Hold for at least 30 seconds. A good hamstring stretch.
Now, keeping your knee straight and hips on the ground, use the band to drop the leg slowly to opposite side. This stretches the IT band.
Tight is it? Now repeat this on the left side. Is it as tight? There you have your measure of imbalance. Work on stretching to get your IT bands to match. Get them to drop 45 degrees or more to the side with little to no pain.
Now you’re using science to maximize performance!
- check your form
- check your training
- stretch, rest and recover
- test your flexibility/range of motion
- balance right and left side to reduces injuries!