The IT band begins in the hip as the tensor fascia latae muscle and has attachments at the origin from three different muscles: the gluteus medius, gluteus minimus, and vastus lateralis. The muscle becomes a fibrous band of tissue as it progresses down the thigh, then crosses the knee joint, and inserts along the lateral (outside) portion of the patella (knee cap) and into the tibia (shin) bone on a bump known as Gerdy’s Tubercle.
The classic symptoms of ITBS are pain along the lateral (outside) aspect of the knee joint, sometimes accompanied by a clicking sensation. The click is a result of the ITB tightening and snapping across the joint during running. The symptoms are often worse when running up or down hills.
ITBS is typically progressive, starting with tightness and often advancing to the point where the pain is debilitating. The traditional view on the cause of this injury has focused on the tightness of the structure and overtraining. There is no doubt that the ITB will become tighter when it is injured. The tightness, however, is more than likely a result of the injury and not the actual cause. The cause of this injury actually lies in the function of the ITB.
The main functions of the ITB are to assist the hip muscles in abduction (outward movement) of the thigh and to stabilize the lateral side of the knee. The ITB is not a strong structure, and if the surrounding muscles have any weakness that can lead to injury and ITB syndrome. Runners are notoriously weak in their hip and core muscles, particularly if strength training or participation in sports that involve side-to-side movement are lacking.
In a study published in the Clinical Journal of Sports Medicine (July 2000), Dr. Michael Fredericson, a physical medicine MD at Stanford University, compared 24 runners with ITB syndrome with 30 healthy runners and found the injured runners to have statistically significantly weaker hip abductors (mainly gluteus medius and minimus) than the non-injured runners.
Initially Rest, Ice, Compression, Elevation (R.I.C.E). If running hurts, don’t do it!!
Foam Roller, self-myofacial release
To prevent ITB Syndrome, as well as including hip abduction exercises in your strength workouts (side knee/leg raises) don’t restrict your exercises to the saggital plane (forward and back) i.e forward lunge. Mix it up with multi-directional lunges with rotations working in all three planes of motion and add some lateral (side) movements, jumps and hops.
My next article will be on the Foam Roller an excellent tool for self-myofacial release and dealing with symptom of ITB Syndrome. In the meanwhile if you have any question please let me know.