A common knee pain struggle out there for athletes is Iliotibial band (IT Band) syndrome. From running, cycling to CrossFit & basketball we see many athletes experience continuous episodes of pain; even after trying the typically prescribed treatments like rest, anti-inflammatories or stretching/foam rolling their IT Band. It is a condition that is generally caused by overuse and is a non-traumatic injury.
Signs and Symptoms llliotibial band syndrome:
- Sharp or burning pain at the lateral (outside) joint line of the knee
- May present with hip tightness (often unrecognised until examined)
What makes up the IT band?
Anatomy:
Insertion points:
- iliac crest
- lateral knee
Muscles involved:
- Gluteus Maximus (G.Max)
- Tensor Fascia Latae (TFL)
The iliotibial band runs from the top of the hip (iliac crest) down to the outer knee which inserts into the Gerry’s tubercle and some of its fibres are believed to span to the outside of the kneecap and head of the fibula. The function of the IT Band being a long fibrous tissue is to act as a stabiliser of the lateral knee, it can also assist in flexing, extending, abducting, medially and laterally rotating the hip when the associated muscles are functioning properly.
It is important to understand that the IT band being a fibrous tissue is not designed to stretch. In a study by Chaundry et al. they showed that for a 1% change in the IT Band length, a force of over 900kg (9,000 newtons / 2000 pounds) is required. To put this in perspective, it close to a pressure of a crane pushing on to your thigh. So what can we do? The focus needs to be focused on the G.Max and TFL muscle portions of the IT Band. These muscle are essential for running or any sporting activities as they involve stability, pelvic balance and propulsion. They are common the big contributors to why the IT Band can feel taut and usually getting a good balance between these two muscles would rid yourself of your knee pain.
llliotibial Band Self care tips:
1. Stop wasting your time stretching things that don’t actually stretch!
2. If you choose to stretch or use a massage ball / foam roller, I’d recommend focusing on the muscles that forms the IT Band such as the G.Max and TFL muscles.
3. Working more on your lateral hip strength: working on the weakness around the hip will improve the balance between the G.Max and TFL which will reduced your IT Band tension.
4. Training modification: Rest and maintaining load is just as important as any form of treatment you can receive. Start with de-loading your volume by 50% and reduced your intensity for the first few weeks. Our goal is not stop all activity, however we need not to flare up our symptoms.
5. Progressive overload: Increasing your weight / distance / volume gradually and not sudden as you feel your symptoms reducing.
6. Speak to our chiropractor the nagging pain is not going away!
Post by: Chiropractor Steven Tran
