IT Band Syndrome – The Causes, Treatment & Rehabilitation

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It’s important to stay informed about all the potential injuries that can arise from running. If you’re engaged in physical training that requires a great deal of running, it’s a good idea to exercise proper caution to avoid these injuries. Almost every part of your lower body is susceptible to strain, inflammation, or rupture, from the thighs down to the lower legs and foot region.

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One such area that is prone to injury from excessive activity is the IT band, or iliotibial band. This is a fairly large portion of your lower body, and abuse or failure to take proper care of it will result in swelling and pain. This can result in the inability for you to continue training and lose progress; in the worst case, it can result in serious debilitating injuries that permanently affect your ability to run. In an effort to help people in danger of being injured, this informative article will explain the nature of the iliotibial band, some causes of IT band syndrome, and methods to treat and prevent IT band syndrome.

What is the IT Band?

The iliotibial band is a band of tissue that connects your pelvis to your knee. It is found around the outside of your hips and thighs, and connects directly to the patella, or knee cap. The the IT band is very large and thick, and can be exposed to a great deal of contact when running, especially if your legs rub together during movement. It’s primary role in the body is stabilizing the knee and ensuring proper mobility in the joints, so that running and other movements can be done efficiently.

What is IT Band Syndrome?

 

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Iliotibial band syndrome, or IT band syndrome, is a painful condition that results from excessive tightness or inflammation in the IT band. It is a very common injury for runners to receive, and the pain is usually located around the knees. The inflammation from IT band syndrome isn’t a particularly serious problem; more often, it’s a warning sign your body is sending for future health problems if untreated.

 

 

 

Causes of IT Band Syndrome

Before beginning treatment of IT band syndrome, it’s important to be aware of the potential causes of it. Once the proper cause of your injury has been identified, it becomes much easier to treat it and prevent it from flaring up in the future. It is still possible to treat iliotibial band syndrome without properly identifying the causes, but this is akin to putting a band-aid on a bullet wound: addressing the symptoms, but not the root cause.

Interestingly, women are more likely to develop iliotibial band syndrome than men. There is no concrete reason as to why this is the case, but a common theory is that some women’s knees are affected by the shape of their hips, causing them to lean inward. The result of this is extra strain on the hips and thighs, causing IT band syndrome.

Excessive Training

Whether starting a physical fitness routine for the first time, recovering from a past injury, or simply trying to strengthen your running ability, it’s important to work your way up gradually. In many cases, injuries like IT band syndrome occur in runners who engage in much more activity than their bodies are accustomed to, or activity that is much more strenuous.

Foot Pronation

Depending on the way your weight rests on your feet, you may be at risk for IT band syndrome. Overpronation while running is one of the most common causes for iliotibial band syndrome; it can be identified by . In general, irregular foot pronation can cause a great deal of running injuries, so it’s a good idea to look out for it.

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Leg Length Discrepancy

This is another common cause of many different running injuries, including IT band syndrome. If one of your legs is longer than the other, it can result in injury due to imbalances in the body and extra strain on the hips and pelvis. Even if the length discrepancy is very small, the effect is still there. Consulting a doctor will help you figure out if there are any differences in the length of your legs, and if that is the cause of your problems.

Running on Uneven Surfaces

When running on a downward incline for extended periods of time, excessive pronation of the feet is highly likely to occur. In general, running on uneven surfaces for a long time puts the body through extra stress. Sometimes this can be useful; for instance, treadmills offer incline settings to increase the amount of calories burned, and stair climbing machines are also popular calorie burners. However, running on a downward incline in particular is bad for your legs and feet, since it results in overpronation.

Muscle Imbalances

Sometimes, the cause of iliotibial pain can be a lack of proper strength in the muscles necessary for effective running. These muscles include the quadriceps, glutes, abdominals, and obliques. If any of these muscles are disproportionately weaker than others in the body, it will cause an uneven distribution of the running load, which can result in IT band syndrome.

List of muscles that can cause IT band syndrome:

  • Quadriceps: 

    Also known as quads, these are some of the largest muscles in the human body. They are located on the thighs, and are connected to the pelvis.

  • Glutes: 

    Short for Gluteus Maximus, this is the other largest muscle in the body. It forms your butt, and is vital for all leg movement.

  • Abdominals: 

    These are also commonly referred to as the abs, and make up the majority of your core. Located near your stomach, this muscle group is vital for posture and running gait.

  • Obliques: 

    Connected to the abs, quads, and glutes, the obliques can be found near the hips and are also part of your core.


Treating IT Band Syndrome

resting-to-heal-injuries-IT-Band-Syndrome-runners-ultimate-guideOnce you have determined that the pain you feel in your hips is as a result of IT band syndrome, you can begin the treatment process. As a general rule, the most effective way to treat this injury, like any running injury, is extended rest. However, you may not want to waste time in recovery, if for instance you are in the middle of a long training regimen. In these cases, trying the techniques listed below should result in full recovery from the ailment within the time frame of six weeks to six months.

Ice/Heat

In order to reduce pain and prevent swelling, alternate between applying heat and ice to the affected area. In general, the best practice is to apply heat before engaging in the activity (usually in conjunction with stretching), and then apply ice after working out. This will help numb the affected parts, preventing pains during your physical activity and afterward.

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Massage

Since the pain from iliotibial band syndrome is most often due to excessive tightness of the affected muscles, massage can be very effective in reducing that pain. In addition to releasing this tightness, massage can also increase blood flow in the tissues, helping improve their performance overall. You can perform the massage either by hand or with the aid of a foam roller, by yourself or with the aid of a physical therapist.

Kinesio Tape

Also known as KT tape, this is special medical tape designed for supporting troublesome body parts when working out. It can be used to treat a number of running injuries, as it is very versatile and strong enough to stay attached to your skin during intense sessions of physical activity. Here is a step-by-step guide to applying KT tape for treating IT band syndrome:

  1. Bend the knee of your affected leg at a 90 degree angle.
  2. Fold one piece of tape in half, cutting into two pieces with scissors. You may want to round the corners in order to prevent the tape from getting caught on your clothes.
  3. Place the first strip on the side of your leg, on top of the painful area. Make sure it is lined up with the upper leg, and add some tension when placing.
  4. Place the second strip of tape over the first strip, lined up with the lower leg. The two strips should form a cross shape on the side of your leg.
  5. Apply a second, full strip of tape from your lower leg over the middle of the cross shape. Continue placing the strip with mild tension, bending along the knee and ending on your upper leg.

Alternative Exercise

If your exercise routine is based entirely around one exercise, consider switching to alternative training activities. Switch to biking, swimming, or using an elliptical machine until the pain subsides. This will allow you to continue being physically active and train your leg muscles, while reducing the overall load on your hips and glutes. After the pain dies down, you should be able to resume running regularly.

Stretching

A good rule of thumb is to perform some light stretching before engaging in any fitness routine. However, in the case of an injury such as IT band syndrome, more extensive stretches may be required in order to keep you from agony. Try some of the stretches listed below before running to relieve some of the tension and hopefully reduce the pain from inflammation in your hips.

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List of stretches for treating IT band syndrome:

These stretches are designed to relieve tightness in the muscles associated with iliotibial band syndrome. Some of these exercises may require additional materials, such as a chair or resistance band.

  • Standing Chair Stretch: 

    While standing, lean on a chair with one arm. Cross the opposite leg behind the leg closest to the chair. Lean your upper body toward the chair until you feel tension in your opposite leg, supporting your weight on the chair with your arm. Hold for 20-30 seconds, then repeat with the other side.

  • Crab Walk: 

    In a squatting, crab-like position, take ten sideways steps. Then, take ten sideways steps in the other position. Repeat this three to five times a day, looping a resistance band between your legs for added difficulty.

  • Side Leg Raise: 

    While lying on one side, lift your leg up 45 degrees off the ground and hold for a few seconds, then slowly lower it back to the starting position. Perform 20 to 30 reps on each leg. For added effectiveness, use a resistance band looped tightly between your legs.

  • Standing Wall Stretch: 

    Stand facing a wall. Cross one leg behind the other and lean in the same direction, balancing yourself with both hands against the wall. Hold on each side for 30 seconds, two or three times a day. This is similar to the standing leg stretch, only more extreme of an angle.

  • Side Lying Leg Drop: 

    Lie on your side on the edge of a table or bed. Cross your upper leg behind your lower, hanging off the edge of the surface. Lower the hanging leg until tension is felt, hold for a few seconds, then return to starting position.

  • One-Legged Squats: 

    Also known as pistol squats. Standing on one foot, with both arms extended for balance, slowly lower your body until your standing leg is completely bent. Then, slowly raise your body back to the starting position. You may need a chair or wall nearby for balance.

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Acupuncture

In conjunction with massage and herbal medicine, acupuncture treatment can be administered to great affect. Some scientific studies have proven the effectiveness of acupuncture therapy to treat a variety of running-related injuries, including IT band syndrome. A physical therapist may recommend this treatment in conjunction with other methods.

Anti-Inflammatory Medicine

There are a few options available for anti-inflammatory medicine. Weaker medicines are available over the counter, usually containing ibuprofen or naproxen. For stronger doses, you may need to obtain a prescription. One unfortunate side effect of some anti-inflammatory medicines is irritation of the gastrointestinal tract. While most of the recommended anti-inflammatory medicines don’t contain steroids, more severe cases may require the use of steroids.

List of anti-inflammatory medicine for IT band syndrome:

  • Ibuprofen: 

    A standard ingredient in over the counter medicine such as Advil and Motrin.

  • Aspirin: 

    A very mild anti-inflammatory, commonly used to treat headaches.

  • Naproxen: 

    A hormone suppressing substance that can relieve swelling and cramps.

  • Diclofenac: 

    Used commonly to treat arthritis and migraines.

  • Bromelain: 

    A holistic medicine derived from pineapple with anti-inflammatory properties.

  • Cannabichromene: 

    A cannabis-based holistic medicine with anti-inflammatory properties.

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Surgery

In the most extreme cases of iliotibial band syndrome, a surgical procedure may be required. This is usually considered only if all other treatment methods fail, and is not recommended unless the IT band pain lasts longer than nine months. A particular surgical procedure used for treating iliotibial band syndrome requires cutting out part of the IT band, and you will need to use crutches or a wheelchair for an extended period of time afterward.

Preventing IT Band Syndrome

Once iliotibial band syndrome has been treated and you are able to resume normal physical activity, you will most likely wish to avoid any occurrences of it in the future. Athletes are at a high risk of IT band syndrome recurring, so taking these preventative measures is highly recommended if you lead a highly athletic lifestyle.

Proper Footwear

The easiest step you can take to prevent any running injuries, not just IT band syndrome, is to ensure that you have well fitting and effective footwear. This doesn’t necessarily mean expensive running shoes: well fitting, solidly constructed and comfortable shoes of any kind will drastically reduce the possibility of IT band syndrome occurrence, in many cases.

Additionally, orthotics such as heel inserts can reduce the possibility of iliotibial band syndrome. It may seem strange that adding support to your feet will reduce pain in your hips, but the general medical consensus is that this is very helpful. Since problems with pronation, gait, and leg length can contribute to the development of IT band syndrome, and since these issues can be treated with orthotics, it makes sense that orthotics are effective at preventing ITBS.

Targeted Strength Training

Since another common cause of iliotibial band syndrome is imbalances in muscle strength, correcting these imbalances by strengthening key muscle groups is very effective as a preventative measure. Specific exercises are recommended by many physical therapists in order to build strength in weaker muscle groups, preventing tightness or inflammation as a result. If you suspect muscle imbalances as a potential risk for you to develop IT band syndrome, you may want to start going to a gym that offers machines to help strengthen key muscle groups, like your quads, abs and glutes.

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Strength-training exercises for preventing IT band syndrome:

Many of these exercises will require the use of additional workout equipment, such as a machine, barbells, or other weights. It is recommended that you perform these exercises at a gym with the aid of a partner, in order to avoid injury. Also, remember to breathe!

  • Leg Press:

    This can be done on a seated workout machine. After setting a comfortable amount of weight, push your legs on the platform until they are fully extended, then return to the starting position. Routines will vary from person to person, but three sets of at least ten reps is recommended. For extra strain on your glutes, try turning your body 45 degrees and push with only one leg.

  • Bilateral Squats: 

    These can be done on a foam pad or an exercise ball. With your legs apart and your back straight, lower your body to the ground until your butt is below your knees. Then, using your quads and glutes, push back up to the starting position. You may want to train with your back against a wall at first, but more experienced lifters can perform this exercise with additional weight such as a barbell. In general, a good routine is three sets of five reps with weight, and three sets of ten reps without weight.

  • Clamshells: 

    There are a few methods to performing this hip exercise. An easy method is to use a clamshell machine at a gym, which will allow you to set specific weights and perform the proper hip movement. Another method is to do this exercise on the floor with a resistance band looped around your legs. In either case, this exercise is performed by slowly opening and closing your legs, for three sets of ten.

  • Planks: 

    Beginning in a standard push-up position, rest your weight on your feet and forearms, holding both your hands together under your head. Keep your back and legs straight, and hold for 30 to 60 seconds. For a more intense exercise, try doing planks with one leg in the air, or by supporting your weight on one arm.

  • Lunges: 

    While standing, take a large step forward with one foot. Lower your body toward your front foot until its knee is bent at a 90 degree angle, then lift back up using your heel and return to the starting position. Do three sets of ten, adding weight in your hands to increase the level of difficulty if needed.

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Physical Therapy: 

Sometimes, there are deeper underlying causes for the development of iliotibial band syndrome that may need to be addressed. The best way to identify these potential causes and prevent them from causing injury is to pursue physical therapy. A standard physical therapy treatment for IT band syndrome includes analysis of your gait, posture, and muscle strength, with the application of proper exercises and equipment in order to resolve any issues found.

Conclusion

While IT band syndrome is one of the more likely injuries to occur in frequent runners, it doesn’t have to stop you from making progress in your workout routine. Thanks to the vast amount of information and technology available, you can easily identify potential causes of this ailment, treat it as it occurs, and prevent it from occurring in the future. The great thing about taking steps toward preventing iliotibial band syndrome is that a lot of these techniques will also aid you in preventing other running injuries, such as patellofemoral pain syndrome and shin splints. Good luck, and happy running!

Sources used while conducting our research

These are the sources linked to in this article with additional information on specific topics. These are all reputable sources: most of them were written by medical professionals or are medical studies published in science journals. However, you should still always consult a doctor or other medical professional if you have any questions about treating injuries of any kind.