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IT Band Syndrome

Originally posted on June 24, 2010

What Is It?
IT Band syndrome is an injury to the long flat connective tissue that spans from your lateral pelvis to below your lateral knee.  Inflammation and friction can cause pain near where it inserts at or below your knee.  Although the IT Band can cause pain in many areas (like your patellar tendon and your hip and low back), IT Band syndrome is characterized by sharp pain locally over the lateral knee.  Typically descending stairs, squatting, running on hilly/ uneven terrain, and cutting sports will aggravate the pain.

What Causes It?
Friction on the bursa where the IT Band crosses the knee joint or excessive tension where the IT Band attaches to the tibia is a common cause of pain.  Pain and inflammation can result from a sudden increase in running volume and will often start during (or after) a hard and hilly run or race.  The IT Band can become irritated from being too tight, but can just as often get irritated from being too overstretched or strained.  Following is a list of predisposing factors:

  • Too much hilly running, or running on uneven terrain too often
  • Running or racing hard in cold weather without proper clothing
  • Poor flexibility in the quadriceps, hamstrings, gluteals, and IT Band
  • Weakness in the gluteal (medius), hamstring, quad, and core muscles
  • Worn shoes that result in too much pronation and/or too little cushion
  • Excessively knock-knee or bow-legged postures
  • Wider hips and/or a narrow running stride (crossing over)
  • Excessive trigger point activity at the front/back edge of the IT Band
  • Frequent leg crossing while sitting
  • Asymmetry/Dysfunction in your spine and pelvis

How Can I Fix It?
IT Band syndrome can be hard to fix unless you know why yours started.  If you are too tight, stretching can help but if you are too weak in some area you will likely not see progress until you improve your strength.  Activity modification is an important first step.  Let pain be your guide.

  • Rest, Ice, Compress, and Elevate for the first 3-5 days
  • Stretch quad, hamstring, IT Band, and gluteals (both legs) if pain free
  • Foam roll along the front/back edge of your IT Band from hip to knee
  • Replace worn shoes right away with a pair that’s appropriate for you
  • Modify your running by decreasing mileage, hills, and hard surfaces.
  • See a PT about what to strengthen to correct leg alignment
  • A PT can also evaluate/correct pelvis & spine problems
  • Core strength is extremely important
  • Myofascial Cupping &Trigger Point Dry Needling can work miracles
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