Thursday, June 9, 2011

Don’t let the warm weather cause you to over do it

Tonight’s guest post is written by my one and only fiancé, Jay, on IT Band Syndrome. Please remember that Jay is a PT student and not a certified PT. If you are seeking medical advice or looking to change your fitness routine, please consult your doctor.

Hello everyone,

Jay here. I wanted to share with y’all an experience I had and teach you a little bit about ITBS, while having a little bit of fun on the way.

A couple of weeks ago, I was running with Sarah when I started to get a nagging pain on the outside of my leg, just above my knee joint. At first, I tried to be a man and ignore the pain but after about 2 more steps I decided that was just silly and stopped. So I did the next-best thing; I whined to Sarah. The pain was debilitating and embarrassing. I couldn’t believe my body had the nerve to fail me like this in front of my fiancé!

Sarah, with her lay-woman’s eyes said “I think you’ve got runner’s knee, better take it easy” while I, with my PT brain, started imagining all the horrible things that could be wrong with my leg- from fracture to meniscal tear- and started freaking out. She was only partially right, I do not have runner’s knee, but I DO have to take it easy with my invincible body.

With the weather getting better and people increasing their mileage, I decided I would explain just what IT Band syndrome is and what you can do if you start experiencing it.

First thing’s first: ANATOMY

The Iliotibial Band (IT for short) is a ligamentous band running from the muscles of your hip (-ilio) all the way down to your knee (-tibial).



But Jay, What Does it Do??

Glad you asked! The IT band does not actually constrict itself but acts like a very long tendon for the muscle at the outside of your hip called the Tensor Fascia Lata (TFL). If you read anatomy books in your spare time, or you have your anatomy notes sitting in front of you- like I do- you’ll notice that the main actions of the TFL are: ‘Abduction, Internal Rotation and Flexion of the thigh.’ Let’s break all that down; abduction is what you’re doing when you put your legs out away from each other during a jumping jack. Internal Rotation is what you do to turn your whole leg so your knee cap is facing in and flexion is bending your hip.

Here comes the tricky part… You don’t do a whole lot of abduction while you’re running (well, maybe some do at the dept. of silly runs), so why is this so important? This muscle is very important because what it really helps with is controlling your hip so it stays level. If this muscle (along with others) isn’t working correctly, your hip on the other side will drop when that leg is lifted up in the air. It also keeps you from tripping over your feet by helping to bend at the hip when that leg is in the air.


This means that the muscle is shortening (concentrically) when your leg is in the air and lengthening controllably (eccentrically) when your leg is on the ground.

Why does it hurt??

Like any muscle, the TFL gets tired and it has a lot of work to do. When you run you are using this muscle almost continuously to help bend the leg and control for hip drop, every step of every mile. You can imagine if muscles could sweat, this one would be drenched. Because of this constant use, the TFL is prone to over-use and injury and may refer the pain all the way down to the end of its ligament, conveniently located just above your knee. It can also become shortened over time and pull the IT band tight over the femoral condyle of your leg, ALSO conveniently located just above your knee. Most people experience this pain shortly after increasing their training schedule or during the run after an especially hard work-out (when the muscle is good and tired). You may also get this if you walk with ‘super-model hips’ that jut way out and keep the muscle super-stretched all the time.

Now for the good stuff: What can I do?

If you find yourself 7 miles from home and you’re experiencing this pain; DO NOT try to run through it! Pain if your body’s way of telling you you’re doing it wrong, so if you ignore it, you’re just going to cause further damage. Most of the time, the pain will go away if you start walking, but if it doesn’t; try to walk peg-leg without bending your knee. That should stop the IT band from rubbing on the femoral condyle and may help with the pain. NSAIDS (Ibuprofin) can help with the pain and using the RICE technique (Rest, Ice, Compression, Elevation) may help also.

To prevent any further injury stretching is a must. Sarah prefers to use a foam roll, just make sure you focus on the TFL and all of the fibers of the IT band from hip to knee. The muscle has more intrinsic elasticity than the band, so it may give you more bang for your buck but the best results will come from stretching the whole thing.


Or you can do it standing, just put yourself in all the opposite motions that the TFL does: place your affected leg behind you in a lunge then bring it into adduction (across midline) and External Rotation (toes out). Once you’ve done this, lean away and you should feel the stretch on the outside, just under your hip.


Strengthening the TFL is a great idea, allowing it to work more, and therefore allowing you to go further. In order to strengthen the TFL, just stand sideways on a step with your other leg hanging off of it and let your hip drop down. Be sure to keep your knees locked and don’t do the motion through your back. Next, bring your hip back up to neutral smoothly and under control. This is an exercise you can do every day but don’t do too much at once, or you’ll fatigue the muscle out unnecessarily.

But don’t take my word for it

While I am in PT school, I am not yet a PT, and I have not looked at YOUR knee, so please don’t sue Sarah if this doesn’t fix your individual symptoms. If you think you have IT band syndrome, or any knee pathology, don’t hesitate to go to a PT. Direct access means you can go to a PT without a doctor’s referral and they can get you tuned up and back on the road-or sidewalk- in no time.

The more you know *ding*