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Injury Management

IT Band Syndrome - Causes and Treatment

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Iliotibial Band (IT Band) syndrome is one of two conditions with the nickname “runner’s knee”. The other, patellofemoral syndrome, also comes from overuse, so it’s easy to confuse the two. While patellofemoral syndrome results in discomfort around the knee cap, IT band syndrome causes pain on the outside of the knee. Combine certain muscular imbalances with the daily dedication of runners, and you can get lateral knee issues. IT band syndrome brings anywhere from mild irritation to extreme pain for some. But what exactly causes it, and what can you do about it?

What is your IT Band?

Contrary to popular belief, your IT band is not a muscle in itself. It’s ITactually an extension of fascia from multiple muscles at the hip. Your tensor fascia latae, gluteus medius, and gluteus minimus conjoin in one long band of tissue that extends down the outer leg. This band is known as the iliotibial band, or IT band, since it runs from your iliac crest to the tibia.

Your IT band is incredibly important to stabilize motion down the kinetic chain. Along with the muscles on which it originates, it keeps your hips and knees in line through dynamic activity. Without it, coordination and locomotion would be difficult.

What is IT Band Syndrome?

IT band syndrome is an overuse condition typically resulting in pain along the outside of your knee. When the long band of the fascia repeatedly rubs against the bone and bursa sac, painful inflammation occurs. Most of the friction comes from repeated flexion and extension of the knee, such as distance running or cycling.

What Causes IT Band Syndrome? 

blog template (1)-1Tightness and weakness of hip musculature, poor postural conditions, and repetitive exercise lead to overuse and inflammation. Your muscles, fascia, and tendons act like a pulley system to move your bones. During knee flexion, the IT band runs behind a bony knob on the end of the femur. As the knee extends, it shifts across this bone, moving forward in order to stabilize the knee through movement.

If one end of the cable is pulled too tight or out of position, the opposite attachment will start to fray. When functioning properly, the outer hip muscles work in tandem to control eccentric abduction through movement. When too weak or tight, it leaves lots of pressure on the band itself. Other muscles step in to do a job they aren’t built for, disrupting alignment around the knee.

While consistent alignment issues are the root cause, downhill running or sudden changes in training frequency contribute to onset of pain.

Treatment for IT Band Syndrome

Addressing weakness in the gluteus medius, gluteus minimus, and tensor fascia latae becomes critical when beginning treatment. Exercise to strengthen the outer muscles of the hip include:

Massage therapy and foam rolling can help release knots in tight hip stabilizers and larger leg muscles. By alleviating the tug-of-war against the joints, your IT band can return to moving smoothly along its groove.  Check out these recommendations for the best foam rollers and massage tools to aid in your relief. 

201702compression-It-band-wrap-putonDuring exercise and rehabilitation, compression sleeves around the knee can help improve proprioceptive feedback during running. It can also contribute to sensory input of pain, slightly desensitizing you to irritation. If you want to keep training with runner’s knee, a compression strap, like the IT Band Helix, for your IT band may be a good solution.

Conclusion

IT band syndrome, while annoying, is completely treatable. Understanding how your IT band works will help tailor your specific treatment. Runners should practice regular strength training for hip stabilizers to maintain dynamic postural health. To counteract existing pain, choose compression straps and utilize recovery modalities. Overall, pay attention to your training, and combine multiple treatment strategies to alleviate symptoms.

Kimber Rozier, Certified Strength and Conditioning Specialist

Kimber Rozier, Certified Strength and Conditioning Specialist

Kimber Rozier is a decorated rugby player for the USA and strength coach who loves sharing her knowledge through writing. As an author, her contribution to Stack, EliteFTS, Men’s Health, and more showcase her expertise across multiple fields. As the assistant coach of women’s rugby at multiple Division I universities, an NSCA certified strength and conditioning specialist, Precision Nutrition nutritionist, and personal trainer, she continues to advocate performance, fitness, weight loss, and an healthy lifestyle.

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