Let me set the stage… you’re running along happily in your own little world, and then out of nowhere you start noticing a sharp pain on the outside of your knee. It’s that dreaded IT band pain. ITB syndrome is common in runners and cyclists and can be incredibly painful and debilitating. The most common recommendation I see for treatment of ITB from both the general population as well as many healthcare professionals is foam rolling. Just smash the sh*t out it with that foam roller and your pain will definitely go away, right? WRONG. Let’s talk about why, and then discuss some alternatives that will actually get rid of that pesky ITB pain for good.
What is the iliotibial band?
The IT band is a thick band of tissue (similar to a tendon) that runs from the hip, down to the outside of the knee. It has many muscular attachments including the quadriceps, hamstrings, TFL (tensor fascia latte) and glutes. It’s primary job is to provide stability to the knee during activities like walking and running, especially when doing downhill.
What are the common symptoms of ITB Syndrome?
Common symptoms associated with ITBS are pain on the outside of the knee, swelling, snapping sensation over the outside of the knee, abnormal movement of the kneecap. Symptoms are commonly worse when running downhill, walking down stairs, with higher running speeds and overstriding.
Foam rolling: should I or should I not?
As I mentioned above, the ITB is very similar to a tendon. It is mostly non-contractile and has minimal elastic properties… AKA: we can’t really change the length or change the “tightness” we often associate with ITB pain. The goal with foam rolling any tissue is to increase the length, flexibility or elasticity of a tissue. Another goal of form rolling is pain modification. You may see some temporary reduction in pain levels due to the pressure from the foal roller. This occurs because the nerve fibers that transmit deep pressure travel to the brain faster than those that transmit pain, tricking your brain. SO… if foam rolling does help reduce your pain in the short term, there’s nothing wrong with continuing to do it
Treatment Tips for Dealing with ITB Pain
Now that we’ve talked about foam rolling, lets go over some treatments that will create a longer term improvement!
Modifying your terrain - ITB pain is common is runners who do a lot of downhill running. Reducing the frequency, duration or degree of decline in the short term while symptom irritability is high can be very helpful for allowing pain and inflammation to reduce.
Decreasing speed/pace - at higher speeds and paces we tend to see an increased incidence in overstriding, which contributes to increased stress on the ITB. Temporarily reducing speed/pace can help reduce symptoms.
Mobility work - I am a big proponent of mobility work, but utilizing the right mobility work is important. Since the ITB has so many muscular attachments, we want to target those muscles that attach into the ITB. Since muscles are contractile, we can alter their elasticity! Remember from above we are talking about the quads, HS, TFL and glutes. My favorite way to target these areas is using a lacrosse ball. Pin the muscle down with the ball and then bend and straighten the knee.
Strengthening - Resistance training is imperative for improving the ability of the leg to absorb forces during running. Focus on strengthening the quads and glutes, especially in single leg, and focusing on eccentric movements.
Give these suggestions a try next time your ITB pain flares up! If you’re interested in 1:1 help dealing with ITB pain or any other pain/injury, schedule a free 15 minute discovery call with Dr. Amber.
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