Iliotibial band syndrome (ITBS) is a common overuse injury that causes mild to severe knee and/or hip pain. ITBS accounts for one in ten cycling injuries and nearly one-quarter of all running injuries. Most people with IT band pain are able to avoid surgery and find relief with physical therapy and lifestyle modifications. Do you think you may have ITBS? Learn the risk factors and how to prevent IT Band Syndrome so you can enjoy your favorite activities—pain-free!
To understand why ITBS symptoms occur, consider the anatomy of the upper leg from the pelvis to just below the knee. Here you will find the iliotibial (IT) band, an elastic, fibrous tendon that runs along the outside of the upper thigh and attached muscle to bone.
Overuse is one cause of IT band pain. When you bend your knee, the IT band slides against the outer part of the lower thighbone. Repetitive knee flexion and extension, as in the case of long-distance running, can lead to IT band irritation.
You may also have pain if your IT band is too tight. A tight IT band is shorter and less flexible. As the knee bends, the constricted tendon rubs against the bones in the upper leg. This friction leads to inflammation in the bones, tendons, and the tiny, fluid-filled bursa that cushion the bones.
Pain from ITBS is described as burning or aching. It typically occurs on the outside of the knee and may run up into the thigh and the hip. Pain may come on after periods of physical activity. In more advanced cases, IT band pain starts earlier in the workout and lingers long after you have stopped exercising.
People who run long distances or participate in other sports like soccer, basketball, skiing, and cycling are prone to IT band pain and tightness. If you don’t warm up or stretch when you work out or play sports, you can develop ITBS.
Weak or imbalanced core and hip abductor muscles also impact your form in a way that causes the IT band to tighten. It’s also true that some people are born with anatomical differences that over-stress the IT band. Bowed legs and excessive foot pronation are two common examples. Gender seems to play a role in ITBS as well, as women are twice as likely to have IT band pain.
Many people will experience ITBS pain at some point in their lives, especially those who are active in high-intensity sports. The good news is this condition can often be corrected without surgery.
Warm Up Before Working Out
It is important to prepare the body for any type of physical activity. A good warm up includes sport-specific dynamic stretches to ease your body into movement and improve range of motion. If you start running immediately while your IT band is still tight, you are more likely to cause irritation to the tissue.
Static stretching is when you move a single muscle into position and hold for 45-60 seconds. These stretches are good for cooling down after a workout. Foam rolling to release muscle tension after a workout is also beneficial to prevent IT band pain and promote relaxation.
Increase Intensity Gradually
The American Academy of Medicine recommends starting a workout with 5-10 minutes of low-to-moderate intensity activity to warm the body up and prepare it for more strenuous exercise. If you run, for example, take a brisk 10-minute walk to warm up and prepare the body for a faster, more demanding pace.
Take the same approach to your overall fitness regimen, adding distance, weight, duration, and intensity in 10% increments weekly. This strategic approach gives tissues time to heal and adapt over time.
Wear the Right Shoes
Believe it not, your sneakers play a big part in your gait, your posture, and your risk of ITBS. If you run, replace your sneakers ever 300-500 miles. The same is true for cleats and other sport-specific footwear. Shoes should fit properly and provide adequate support to absorb shock and encourage the preferred movement pattern.
Run on Even Surfaces
If your sport or activity of choice involves a lot of running, be sure to do it on flat, even surfaces or gentle hills. Running downhill for long periods of time increases tension on the IT band and stresses the quadricep muscles. Fatigued quad muscles are less effective at stabilizing the knee joint, increasing the chance of a knee injury.
Practice Good Form
Proper form for running and other forms of exercise allows you to explore a full range of motion, moving efficiently without taxing certain joints and muscles. Improper form causes the body to expend excess energy to compensate for less inefficient movement. Good form sets the body up in the strongest position possible for natural, healthy movement. That’s going to help reduce ITBS and other sports injuries.
Increase Muscle Strength
To ease stress on the IT band, build up the muscles around it. Strength-training exercises for the quadriceps and the glutes are going to not only prevent IT band pain. They will also protect the knee and the ankle against other injuries as well.
Core strength is also beneficial for good balance and stability. Weak or inflexible core muscles affect the function of your arms and legs. A physical therapy plan that includes strategic exercises to target these key muscle groups helps prevent ITBS.
Return to Activity Slowly
Take your time getting back into action after any injury, including ITBS. True recovery takes time and a comprehensive physical therapy regimen to rebuild strength and endurance can help. If you overdo it too soon, you’ll increase your chance of reinjury.
Listen to Your Body
Finally, pay attention to the clues that something is going on in the body. Pain is a sign that something is wrong and needs to be addressed. In some cases, all is needed are a few days off to rest.
But persistent or intense pain, stiffness, and mobility problems may be signs of a serious injury. Schedule a physical therapy examination and see your health care provider for IT band pain and other unusual symptoms.
If you’re reading these tips too late and you’re already in the midst of an ITBS flare-up, help is available. As “movement experts,” physical therapists are specially-trained to diagnose and assess ITBS and other musculoskeletal conditions that cause knee pain and hip pain.
Through massage, exercise, and manual therapy, you and your physical therapist work together to combat and correct the issues causing IT band pain. If you run, bike, or play sports, your therapist helps you build muscle strength to encourage and support proper posture.
Not only can physical therapy help reduce your pain today, but it can also change the way you move to prevent symptoms from recurring. Are you ready to take the first step toward a pain-free future? Find a physical therapy clinic near you.