Shake IT Off- Dealing with IT Band Syndrome

Illitibial Band Syndrome or what most people refer to as, IT band soreness/tightness. It's the ligament that basically runs from the glutes/hips down to your shin. The term is often heard in a group of runners due to the constant stress of pounding the pavement, especially when they aren't performing proper (or any) stretching post-work out. In my opinion, the larger and stronger your quads and hammies get, the tighter these ligaments like to pull and create complete havoc if you don't take care of them with proper recovery techniques. Of course, it all starts with genetics, our muscle fiber types, our bone structure etc. But, we do know that our genetics do not define us, they may limit us to an extent, but we can also improve our limitations despite hereditary predispositions to typically, a much greater extent than that which we feel may be possible.

Basic Facts

• Typically comes on as outer knee pain, and often accompanied by what is described as a clicking feeling.
• Symptoms typically become worse running up/downhill and on concrete. 
• ITBS is not usually a sudden "injury" but rather a progressive tightening that eventually turns into a debilitating issue.
• Two biggest promoters of IT Band tightness- overtraining and lack of proper recovery.

So, you've got ITBS and you want to keep running. What now? Once you have gone to the doctor and know the cause of your ITBS, you can begin rehabbing it.

1. Rest. When your ITBS starts to come on strong, the more you run or exercise on it, the worse it is likely to get. So, if you are just now at the peak of your pain, you need to take a  couple weeks off. 

2. Begin stretching. At least three times a day, holding each stretch for at least 30-90 seconds. There are several specific IT band stretches that I will illustrate below using some photos (not my own). It is also important, however, to include the entire surrounding muscles such as the glutes, quads, hamstrings, calves and shins. 

Photo Source

Photo Source

Photo Source

If the standing figure four stretch shown above is too difficult, you can always try holding onto something to keep your balance, try it seated as shown below, or even try it lying on your back. 

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Don't forget to ice after you finish stretching. 20 minutes on. You also have the option of heating the area before you stretch to help ease into your more intense stretches. Using a heating pad for no more than 10 minutes will do the trick. 

3. If you need to keep your fitness level up: cross training with something low impact like a bike, elliptical or water jogging can help to get the heart rate up enough to maintain cardiovascular fitness.

4. Deep tissue massage: focusing on the entire length of the IT band and surrounding muscles. This can be done 2-3 times a week and actually up to every single day. However it is pricey, so a less expensive option is a foam roller. 

5. Self-myofacial release using a foam roller: Just like our stretches, we will not only foam roll the IT bands, but the surrounding areas as well. If one IT is tight, you still want to mimick exactly what you do on the sore side, on the healthy side. When foam rolling, always stretch the muscle you are preparing to roll first, then roll it for 1-3 minutes. Start at the top of the muscle and slowly work your way down stopping completely at any points you feel pressure and holding that spot for 30 seconds. You can make your way all the way down the IT band and then all the way back up, 1x each. Here's a photo of what this particular move should look like:

Photo Source

One thing you should be aware of about foam rollers is that they come in a variety of sizes and densities. The one pictured above is a grid type roller which is very dense and gets very deep. The black traditional foam rollers are the next level down, followed by the white foam rollers which are the softest. Many people who have extreme tightness have to start out with the white foam roller, particularly on the IT bands. 

6. When you are starting to feel better and seeing significant progress after a few weeks of stretching, icing and rolling, you can go ahead and start trying out some strength exercises to help prevent ITBS from flaring up again. Here's a few examples of great exercises to start with:

Lying, outer thigh straight leg lifts

Standing, outer thigh straight leg lifts

Add a very light theraband around thighs just above the knee and perform outer thigh lifts lying or standing

As you progress, you can start walking 10 steps each with with the thera band. Then, when you've really started to gain some strength, add in a squat between each step!

Runners/athletes- Have you experienced ITBS? What was the best therapy for you?