Do you struggle with running at the same level you used to be able to do a couple of years ago? Do you have knee pain when you hit the pavement for your run? In this article we’re going to cover the 5 things you need to know about Iliotibial Band Syndrome!
If you are more of the visual and auditory learner just click the YouTube video below outlining everything that is in this article!
What is IT Band Syndrome?
This is the most common overuse injury in runners. The iliotibial band is actually connective tissue that connects to a muscle in your hip. This muscle is the Tensor Fascia Latae or simply referred to as the TFL. This is a small muscle on the outside front part of your hip. This connects to the iliotibial band which runs down the outside of your thigh and connects into the bone that crosses the knee joint. Where you really run into problems is where the ITB crosses the knee, that’s where we see most of the pain in our patients. So, the IT band is connective tissue, not an actual muscle, which is why it’s called a band. It’s fibrous connective tissue like the fascia in the body. The reason why it’s going to be really tough to stretch this structure is because it’s a tough connective tissue and the majority of it is this long band and then the small little muscle in the hip. Technically you can stretch the muscle in the hip, but the band itself you cannot.
Iliotibial band syndrome is more common in females. The rationale and reasoning behind this is because women have a larger pelvis! The wider pelvis puts women as a disadvantage when it comes to running!
How do I know if I have it?
There will be very localized pain to the outside part of the knee. The pain will be very specifically pinpointed to the outside part of the knee. Sometimes this pain can be confused with a meniscal tear. A meniscal tear is completely different from ITB syndrome. A meniscal tear occurs from a specific event or trauma and is normally associated with clicking or a catching feeling in the knee. Iliotibial Band Syndrome occurs overtime with what we call an insidious onset. Maybe one day you’re running and feel a little bit of pain and then the next run it’s worse and then it’s highly irritable and you can’t ignore it. That’s when we would start consider Iliotibial band syndrome.
A common question people have is do I need imaging such as an X-Ray or MRI to determine if I have ITB Syndrome? The answer is no! The history and onset is normally a clear give away and then a good physical exam by your running physical therapist will help to differentially diagnose and determine if you pain is in fact Iliotibial band syndrome. An x-ray will not show anything regarding this diagnosis as x-rays show bone imaging. An MRI would show the iliotibial band but it won’t show any damage to the tissue itself. Based on this, you want to see your physical therapist first instead of needing to go to an orthopedic physician who is a surgeon. In case you were not aware, you do not need a prescription first to go see your Physical Therapist, you can go directly to your PT for a diagnosis!
What causes it?
ITB syndrome is mainly a repetitive overuse injury. As your knee is bending back and forth during running you’re causing irritation to the tissue. Another sport that is common for this syndrome to occur is in cyclists and triathletes who are cycling and running performing many repetitions of repetitive knee bending. Another aspect that can cause this condition is if your leg rotates in. If you’re flat footed and you overpronate during running, your leg will rotate in and can cause more stress on the outside part of the knee. Something else we want to pay attention to is the surfaces that we’re running on. First of all, look at your sneakers. If you’re getting a lot of wear and tear on the outside of your sneakers, that may be a good indication that your foot is pronating and rolling in too much. If you’re running on a lot of country road and the road that you’re running on is banked, you’re always going to have one side that is higher than the other, and you’re leg is going to be rotating inwards. This can be a contributing factor and cause as to why you’re getting ITB syndrome. Another factor can be if you’re running on a track going only one way, you’ll get that same situation where one side is higher than the other! These are all contributing factors that may lead to Iliotibial band syndrome.
How do I get better?
So how do we treat Iliotibial band syndrome? First and foremost, you’re going to need to back off your mileage. We’re not saying shut down running. However, if you’re having current pain, you need to back off a little bit so that you can allow some healing to start. You need to think about switching up the surfaces! If you’re running on those banked surfaces, you need to think about running on some flat surfaces. If you’re doing a lot of mileage on a track, think about some safe roads that you can run on or switch it up on the track and run the other direction. It may look silly but it’s healthier for YOU! If shoe wear is the contributing factor, you should be counting your mileage. You should be switching your shoe wear every 300 to 400 miles. Track your miles so that you’re aware of how much you’re putting on your sneakers. Only wear your running sneakers for running so that you can track how much damage those shoes are taking primarily from running.
Next, you’ll want to foam roll your iliotibial band. However, Do NOT roll on the outside part of your knee where you have all of your pain. You won’t feel any better and you’ll just cause the pain to increase. You’ll want to roll the Tensor Fascia Latae muscle in the hip and then roll in front of the IT band and slightly behind the IT band. This will cause a decompressive effect to the actual band! Do not roll right on the side and go for the kill, it’s extremely painful and you won’t feel any better! Click this LINK to see my personal recipe on how to foam roll the TFL and ITB.
You’ll need to strengthen the glute muscles. Primarily, you’ll want to focus on the gluteus medius muscle which is your outside hip muscle. This muscle stabilizes your pelvis when you are running and you step on the leg. Every time you step on your leg, every time you’re running you are only stepping on one leg and the gluteus medius helps to stabilize here. We want strengthen this muscle primarily to prevent the leg from dropping in as that can be a contributing factor to the development of ITB Syndrome. This is by far one of the most important muscles runners need to focus on strengthening! Click this LINK to see my favorite gluteus medius isolation exercise for runners to wake this muslce up!
How do I prevent it?
This is actually the fifth tip in our five tips of healthy running! You have to train smart with proper progression! We don’t want to go out there and ramp up our mileage out of nowhere. You need to be smart about your training. You always want to think about your shoe miles. Take a look at your shoes BEFORE you get your pain. Are you tracking 500 miles? Go replace your shoes! That way you can prevent the condition before it happens. Next, we want to think about strengthening! Strengthening your hip muscles, quad muscles, your core muscles! Running is a repetitive activity and you want to be strong in all areas. You want to train smart so that as you progress as a runner, you will be able to run to your best ability!
Check out all 5 of my healthy running tips in this previously posted blog article by clicking THIS LINK
Are you a runner looking for a community that is dedicated to helping you stay happy and healthy doing what you love?
You could be an active adult starting out with a couch to 5k program or you may be an experienced marathoner!
The FREE Healthy Runner CT facebook group is your answer!
Our specialty here is prehab, rehab, recovery, and performance for all types of runners!
CLICK HERE to join our community http://bit.ly/HealthyRunnerGroup
Are you a runner that is trying to stay healthy but can’t train because pain is stopping you from meeting your goals?
Are you worried that an injury will limit you from doing what you love like working out and training?
Have you wondered what it will cost you in the long run if you continue to train through pain?
Have you seen other medical providers in the past that just tell you to stop your activity?
We have a unique treatment approach that focuses on solving these problems with our clients. We combine manual hands-on techniques with guided supervised exercises to help you get stronger, pain-free and perform at your peak level to get you back on the road doing what you love. Our goal is to help keep you active and on the road, while recovering from injury by guiding you in ways to modify your training, rather than eliminating running!
The SPARK Physical Therapy Commitment
No long waits or multiple trips to providers’ offices every week. We see you either onsite at a partnering gym or in the comfort of your home when it is convenient with your schedule.
One on one for a full hour with your doctor of physical therapy, every visit. We provide you with a customized plan specifically designed for you, based off your unique injury and goals.
Full transparency in what you pay. You will never get a bill from us a couple of months after your visit.
Access and availability to you! Have a question about your pain or exercise program? Get an answer from your therapist directly.
If you’re in the greater Hamden, CT area and are a runner that has been dealing with injuries we can help. We’d love to chat for a few minutes and see if you are a good fit for what we do. Fill in this CONTACT REQUEST LINK and we’ll set up a free-minute phone consultation with a doctor of physical therapy
Thank you for taking the time to read,
– Duane Scotti, PT, DPT, PhD, OCS
A special thanks goes out to Allie Eldridge, SPT for her contributions to this article
Runners! Have you ever experienced foot pain? Are you frustrated that you are receiving poor advice about your foot pain and your foot pain is not going away? I know I’ve been there. I was ignored and wasn’t taken seriously. I was told I shouldn’t be a runner! Well, that resulted in a total of… View ArticleRead More
Runners! Do You Have Nagging Injuries? Do you wake up every morning with an achy pain on the bottom of your foot when you get up to go brush your teeth? Or are you a runner who has been feeling knee cap pain during your runs, going up and down stairs, and when you squat? … View ArticleRead More
Have you ever been in a dance class or rehearsal and rolled your ankle? Have you prepped for a jump and upon take off felt a sharp pain in your ankle? The ankle sprain is by far the most common injury among dancers and in this article we are going to address the diagnosis, prognosis… View ArticleRead More
Hey everyone! In this article, we are going to be talking about 3 tips for healthy raking! Have you ever went outside for your fall cleanup and you raked and then you’re back was killing you for days after that? Or are you someone who has back pain and you’re worried that if I go… View ArticleRead More
Do you struggle with running at the same level you used to be able to do a couple of years ago? Do you have knee pain when you hit the pavement for your run? In this article we’re going to cover the 5 things you need to know about Iliotibial Band Syndrome! If you… View ArticleRead More
In this article we will be discussing the one test your doctor must order for you when you are in pain as well as what to expect during your first physical therapy appointment. You could be a runner, dancer, gymnast, or an aerial circus artist who is having pain in your knee, foot, or shoulder. … View ArticleRead More
Are you a runner, dancer, or gymnast who suffers from chronic tight hips? Or are you a person who has heard that you should be foam rolling but are not sure where to start? In this blog post, I will share the reasons why I prescribe foam rolling for the hip flexors that has helped… View ArticleRead More
How do you know if you’ve sprained your ankle or broken your ankle? You’ve rolled it and you have some pain and some swelling. As the onsite Physical Therapist, Dr. Scotti is available to help triage the situation and help to determine right away if there is a break or a sprain. If you… View ArticleRead More
Do you have pain in the back part of your upper thigh or near your butt right on your “sit bone”? Is this pain preventing you from running? In this article we’re going to discuss ways to stop this pain in its tracks to get you back on the road doing what you love as well as to prevent it from coming back!Read More
“I went to see Duane early into my marathon training with hamstring pain. At that time, I was barely able to run 3 miles and was in pain. After a thorough exam and analysis of my running, he was able to diagnose and start treatment that day. Duane provided me with exercises to strengthen my hamstring and surrounding running muscles, all while slowly building my mileage back up. He was honest with me about setting realistic goals for my race and helped me to meet those goals. With his help, I was able to run the New York City Marathon.”
“I first went to Duane prior to training for my first full marathon because I had some aches and pains from running that I wanted to sort out. Duane was able to diagnose the problems immediately and I went home pain free. The exercises he prescribed were personalized to my needs and within a few weeks, I felt stronger and pain free while running so I could get to healthy training! It’s great to have a physical therapist who understands athletes and encourages people to continue to stay active. I highly recommend Duane to any person who is looking to stay healthy while maintaining an active lifestyle!”
SPARK Physical Therapy was instrumental in my recovery of from achilles tendinitis. I visited a podiatrist who said I would need surgery to shave down a bone spur and Haglund’s Deformity. The recovery would be at least 8 weeks and at the time I was 24 weeks from running the NYC Marathon. Duane evaluated me and said I needed to work on my calf muscle and flexibility. We started treatment with dry needling and specific exercises that I could do on my own. The pain subsided and even after some long runs everything was starting to feel better. I will tell you that I ran and finished the NYC Marathon without pain or issues from my achilles. Had I not met Duane about a week after my podiatrist appointment I would have needed to defer my marathon and probably would still be recovering from the surgery. I was able to run through my injury safely and achieve my goal. The refreshing thing about SPARK Physical Therapy is they do not push for ton of session. I met my running goals in 10 sessions spread out over 3-4 months. Big Thank you to Duane and I highly recommend seeing him for any running injury you may have!
Just fill in your info below and we will send these to you right away!