By Mark Plaatjes, RPT
The iliotibial band (commonly known as the IT band or the iliotibial tract) is a thick fascial band that runs along the lateral side of the upper and lower legs, from the iliac crest across the trochanter down to the lateral superior rim of the tibia and to Gerdy’s tubercle on the lateral side of the tibia. It is one of the key stabilizers on the lateral side of the knee; it also plays a role in helping absorb the shock from the impact force of every foot strike.
Iliotibial band syndrome is a common running injury that occurs when the iliotibial band becomes inflamed or irritated by repetitive movements of a runner’s stride or tension caused by muscular imbalances that pull the leg out of proper alignment. Iliotibial band syndrome is sometimes referred to as ITBS, IT band syndrome, ITB syndrome or and ITBFS (iliotibial band friction syndrome).
The important fact to remember about the iliotibial band is that it is a ligament, so you don’t want to try to stretch it if you are experiencing pain, irritation or inflammation. There are three muscles that attach to the iliotibial band that can make it feel very tight and painful. The gluteus maximus, the tensor fasciae latae and the vastus lateralis. The biggest culprit to the iliotibial band among those three is usually the vastus lateralis, but all three muscles should be stretched and rolled often, even if there are no signs of iliotibial band tightness.
Iliotibial band syndrome is one of the more common running injuries and it can be caused by several key factors:
1. Training Errors
– Doing too much running or running with too much intensity or speed too soon;
– Changing running surfaces, especially after running mostly on trails and then all of a sudden running a long run or a fast race on roads;
– Running too many hilly runs or hill repeats without proper warmup, stretching, rest or recovery;
2. Running Mechanics
– Excessive pronation, or the inward rolling of a runner’s foot and ankle, can cause excessive medial femoral rotation and lead to a tight iliotibial band;
– Weak abductors, weak rotators, weak gluteus medius can cause an imbalance and lead to ilitotibial irritation and tightness;
– Excessively tight quadriceps muscles;
– Leg length inequalities, caused by either a functional or structural discrepancies in the length and alignment of the legs from the lower back to the feet.
3. Improper Shoe Selection
– Shoes without enough support for pronation can lead to excessive pronation over every stride;
– Shoes without enough cushioning can force the iliotibial band to take too much of the burden of the absorbing impact shock of every stride.
Iliotibial band syndrome is a complex injury that needs to be treated correctly and thoroughly, otherwise it can persist, remain painful and limit the ability to run or walk without discomfort. Rest, ice, compression and elevation (RICE) and anti-inflammatory medications can be among the initial treatments, but more comprehensive physical therapy is often necessary to reduce the tension on the iliotibial band.
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