How to Prevent and Cure ITBS

Audio Transcript

Claire: Hello everyone and welcome to the Runners Connect podcast.

We have a great question today from Deb.

Deb says, “What are the signs of IT Band Syndrome. I have outer hip pain. Sometimes my knee hurts, and sometimes it doesn’t. Long runs make it worse. Sometimes the leg stiffens up and I walk awkward. Can you tell me if this is IT BS?”

It does sound like you are describing ITBS Deb or Iliotibial Band Syndrome.

It’s generally described as pain coming from anywhere along the muscle, on the outside of your thigh, from your hip all the way down to your knee.

This is not an injury that you can run through or that will eventually go away on its own, and it will get worse if you don’t take action to correct it.

Today, I’m going to go over what causes IT Band Syndrome and how to fix it, so you can get back to running without pain.

The Iliotibial Band Syndrome or the IT Band is a long band of thickened, fascia tissue that runs from the top of the hips, down the outside of the thigh, pressing the outside of the knee, and inserting at the very top of the tibia.

It’s not a tendon; its stiff connective tissue that encapsulates the muscles of the upper leg and connects many of the major hip muscles, all the way down to the knee.

Its main function during running seems to be stabilizing the knee during your foot strike.

IT Band Syndrome is an injury to the IT Band that most commonly incurs on the outside of the knee or just above it. Though it is not unheard of to get pain further up the outside of the leg, even as far up as the top of the femur.

ITBS is a common running injury that affects both recreational runners and elites, so you are definitely not alone, Deb.

What are the symptoms? Your IT Band usually gets sore after a set distance into the run, so you might feel okay for a mile or two, but the outside of your knee or thigh will start to ache or feel stiff, or you might even have a burning pain sensation.

It typically hurts worse when going downhill, and you might sometimes feel pain when sitting with your leg bent for a long time.

What causes IT Band Syndrome and how do you stop it? Well, just before the IT Band crosses the knee, it runs along the top of the femur, and it’s squeezed against the bone, which irritates this area and causes you a lot of pain.

How does that happen? Well, the short answer is improper running form and hip weaknesses.

In a healthy and strong runner, these muscle groups keep the hip abducted and the knee externally rotated, which will limit the pressure on the IT Band, but when these muscles are weak, the hip adducts and the knee internally rotates after impact with the ground.

It crushes the IT Band and all the underlying sensitive tissue against the bone, ouch!

Take a look at your stride; if you tend to cross over the midline of your body with your arms and legs instead of pointing your feet straight ahead, you are at a higher risk for ITBS.

Add in factors like old shoes or running on cambered road surfaces, even tight turns on indoor tracks, and you increase the risk of injury.

What’s the solution? In short, strengthen your hips and glutes so that you’re running strong and straight, without crossing over the midline of your body anywhere in your stride.

ITBS is a biomechanical problem which needs a biochemical solution, and this is where hip strengthening exercises come in, and you can find those on our website at runnersconnect.net.

Basically, your number one priority should be to strengthen your abductors and external rotators so that you are not running pigeon toed.

We want your toes to be straight ahead of you, not turned in and not turned out, so nice, straight feet when you land.

If you’re consistent with these exercises daily, you should expect to see major improvement in about four to six weeks, so there’s no overnight solution.

If you’re consistent, in about a month, you should see a big difference in your symptoms.

As far as stretching the IT Band, that’s not really a good idea, because it’s not stretchy tissue. It is more like a car tire than a rubber band, so stretching the band itself is not going to help.

You should be targeting the muscles that are attached to the IT Band, so that’s like the gluts and the TFL, which is the muscle on the outer hip.

Formalin the muscles around their IT Band can help as well, but be sure to avoid rolling right over the painful area, because you can make the pain worse, which is obviously a bad idea.

I can tell you a little story from my own experience with this. I had some IT pain after running my second marathon, and it lasted about two weeks.

I went to go see an amazing massage therapist who discovered that my opposite ankle was out of alignment, and so I was compensating for my ankle with my other leg, causing my stride to become off balanced, and putting pressure on the IT.

Once my ankle issue was corrected, the opposing leg pain disappeared. Now that’s just anecdotal evidence, but if you are looking for an excuse to get a massage, you certainly can use my story as validation.

How do you get back to running? Since IT Band Syndrome is the result of the biomechanical problem, your ability to return to running will be determined by your progress in your hip strength, so religiously do those hip strengthening exercises.

Right after you get injured, you will probably need a few days off of running, maybe even a few weeks if it’s really severe, so that the initial inflammation can subside on the outside of your knee.

Once that initial irritation is gone, you will probably find that your IT Band still gets a little irritated after a few miles of running, if you haven’t been working on that hip strength.

Like I said before, it takes about a month of daily hip strength exercises to completely recover from this, but you might be able to run easy during this time period, just as long as you are keeping your runs short enough, that you aren’t running in pain.

I hope that helps answer your question Deb, and thanks so much for sending it in.

For those of you listening that want to have your question answered by one of the Runners Connect coaches, head over to runnersconnect.net/daily, click the record button and send your question over to us.

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That’s it for today folks and have a great run day.