What is IT Band Syndrome?
IT band syndrome, a common overuse injury for repetitive sports is thought to be due to either of the following:
The following can are thought to be the cause:
Inflammation of the insertion of the IT band on the outside of the knee.
Compression of the fat pad that sits beneath the IT band at the knee. The fat pad is highly innervated (contains lots of nerve endings) so becomes sore when compressed.
Chronic inflammation of the bursa (sac of fluid) between the IT band and the side of the knee joint.
Symptoms include:
Tenderness and sharp pain on the outside of the knee.
Swelling of the affected area.
Gradual worsening of pain whilst performing repetitive movements (Running/Cycling)
Soreness when bending or straightening the knee
Pain on the outside of the knee when ascending or descending stairs.
What Are Causes of IT band Syndrome?
Overload/Training Error:
Overload or excessive training intensity/volume is a common contributor to IT band syndrome. When athletes increase the intensity or volume of their training too quickly, the IT band can become overloaded and strained as the tissue does not have enough time to recover and adapt.
Muscular imbalances:
Muscle imbalances play a significant role in the development of IT band syndrome. Weakness in the hip abductor muscles, such as the gluteus medius and gluteus minimus, can result in poor stabilization of the pelvis during activities like running or cycling.
This instability places greater stress on the IT band, leading to increased friction and irritation as it rubs against the lateral epicondyle of the femur.
Additionally, tightness in the muscles surrounding the IT band, including the tensor fasciae latae and the vastus lateralis, can further exacerbate this friction by limiting the IT band's ability to glide smoothly over the underlying structures. Addressing these muscle imbalances through targeted strengthening and stretching exercises is crucial in preventing and managing IT band syndrome.
Biomechanics:
Poor biomechanics significantly contribute to the development of IT band syndrome. Issues such as foot pronation, where the foot rolls inward excessively during movement, can alter the alignment of the leg, placing increased stress on the IT band. Similarly, leg length discrepancies can lead to asymmetrical forces through the lower extremities, affecting the distribution of weight and causing abnormal movement patterns.
Additionally, improper running or cycling form, such as overstriding or excessive inward knee rotation, can also increase the strain on the IT band. Addressing these biomechanical issues through corrective exercises, footwear modifications, and gait analysis is essential in reducing the risk of IT band syndrome and improving overall performance.
Gait Mechanics:
Running mechanics, such as overstriding, pelvic instability, cadence, and foot strike position can exacerbate IT band pain. It is important to have your gait analysed so you know whether or not this is impacting your knee pain.
How To Improve Your IT Band Symptoms:
If you are suffering from IT band pain you likely need to work on one or more of the areas above.
This will include:
Glute/lateral glute strengthening exercises to help improve pelvic stability
Gait retraining
Discussion around training load/volume
Orthotics
If you are unsure about what areas need to be addressed I would recommend an assessment to determine your next best steps. A common mistake people make is doing some exercises they found on Google for a few days/weeks and finding out they are not doing anything to relieve their pain.
To see improvement in the short and long term you need to work out the following:
The right level and intensity of exercises focused on developing the muscle groups that need improving.
What your training volume should be over the week.
Whether or not you need to make changes to your running technique.
Feel free to contact me to organise an assessment; I would be happy to help.
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