One of the most common issues I am presented with as a therapist is the IT band. The dreaded IT band that all athletes, especially runners and cyclists, have no doubt come across in their life. But don’t worry… your IT band isn’t as evil as you think! Its trying to help you.
Quick Anatomy Overview
If we took this from a basic anatomy point of view, the Iliotibial Band (IT band) originates from the Tensor Fascia Latae muscle, and thus the Iliac Crest of the Pelvis, and inserts below the knee to the lateral aspect of the Tibial head typically where you may get symptoms of what is called ‘Iliotibial
Band Syndrome’ or ‘ITBS’.
The IT band is not actually a muscle but rather a fascial continuity of the Tensor Fascia Latae. If I am being completely honest, the IT band is more like a tension cable keeping the Tensor Fascia Latae pinned down to the outside of your thigh so it can do its job. It is effectively an enlarged tendon, making ITBS just another form of tendon inflammation, or tendinitis as you’ll know it to be.
Foam Rolling is a NO from me!
It’s quite likely that if you have ever spoken to a fellow athlete about your IT band you have been told about ‘The Foam Roller!’
The Foam Roller is a self massaging tool that 9/10 people would use to run up and down their IT band causing serious amounts of pain. But that doesn’t matter because pain is good! It must be working… Right?!
Stop right there!
What you’re doing here is taking a purposely elongated and stretched piece of tissue that is already inflamed and damaged, and attempting to ‘treat’ it by beating it to death with a foam roller. Doesn’t make sense now does it? You will get a temporary release of symptoms, but if you want the issue dead and gone, its not the way to go.
The Real Issue is with your Glutes
We already know the IT band is attached to the Tensor Fascia Latae. Together with the Gluteus Medius (GMed), the Tensor Fascia Latae works to stabilise and abduct your hip which is the movement of bringing the leg out away from the body.
GMed is, unquestionably, one of the most important muscles in your entire body.
GMed is your MAIN hip abductor. If this muscle is neglected and becomes weakened, then it leaves your Tensor Fascia Latae with no option but to go it alone. This will effectively cause overuse and shortening of the TFL, strain along the IT band and cause you pain… In a nutshell.
Think about this for a second…
Large structures are usually held up by a collection of tension cables, in the same way the hip is stabilized by a collection of different muscles. If one of these wires becomes weak and puts excess stress on another cable, would you try to relieve the stress on that cable? or would you fix the one that is weak and make the whole structure stronger again? Because by attacking the IT band, you’re opting for the first one.
In my mind, you always add strength back to the one that is weak so it can take back its fair share of the tension and make the entire structure as strong as it can be. Give your body something back, don’t always take away!
So how do we solve this problem?
Step 1: Strengthen your GMed so it can take its fair share of the load through gentle exercise
Step 2: Relieve some tension in the TFL through Massage and Therapeutic Stretching
Unfortunately, isolating the GMed is a hard task to achieve as it requires precise spinal alignment and pelvic positioning. Similarly, the TFL is very difficult to effectively stretch by yourself…
That’s where sport massage therapy comes in…