Updated: Jan 6
Have you ever had recurring knee pain when walking, running or squatting? You're not alone: Thousands of people are suffering from the dreaded IT Band syndrome. We see and treat people with this kind of knee pain all the time, and have been able to get them back to the activities they love. In this article we'll guide you with the information you need to get rid of this annoying pain.
What is an IT Band?
ITB is short for iliotibial band. It's a thick band of fascia structure on the outside of your upper leg. It originates from a muscle on the side of your pelvis (the TFL or Tensor Fasciae Latae and some fibres of the gluteus maximus) and inserts just below your knee. It flexes and extends the hip and helps with rotation of the leg as well, and plays an important role in knee stabilisation.
One of the most common and dreaded injuries associated with the ITB is called IT band syndrome
What causes ITB tightness - what causes pain on the outside of the knee?
IT band syndrome occurs when the IT band becomes painful due to irritation and overuse: flexing and bending the knee repetitively. When we repeatedly engage in a movement; like bending and extending the knee, this can cause friction and irritation of the area. This almost always happens when the IT band is too tight and causes friction on the outside of your knee. This can result in pain and / or inflammation and is very common in active people.
When will you experience the most pain?
The discomfort, irritation or pain from this issue will most likely be when moving: running, walking or squatting (with or without weights) will usually offset the symptoms due to the friction on the outside of the knee. Resting will normally ease these symptoms, although it may take a while before this annoying feeling disappears.
Why does the IT band get tight?
This is the most important question to answer in order to get the right treatment in place.
In many cases, we see a biomechanical issue that's a big contributing part. It could be an issue with foot mechanics or lower leg dysfunction; where one of the bones in the lower leg isn't moving well. It could also be higher up the leg, or even in the lower back.
When one of the lower vertebrae in your spine is stiff or when there is tightness in one of the muscles in the pelvis, this can cause the pelvis to tilt. Even if this tilt is slight, it will result in more tension in the IT band. The discomfort, irritation or pain from this issue will most likely be when moving. Running, walking or squatting (with or without weights) will usually offset the symptoms due to the friction on the outside of the knee.
Resting will normally ease these symptoms, though it may take a while before this annoying feeling disappears.
You’ll need one of these if you want to roll your IT band! :-)
How to treat ITB pain?
Let's start with explaining what will NOT resolve your problem. Many health practitioners focus on the symptoms and will give treatment on the painful spot: somewhere around the knee. This is unlikely to solve your issue because although this is the spot where your pain or tightness is, it is not necessarily the cause of the problem.
Another unhelpful treatment option: foam rolling your ITB! We see so many active people foam rolling their ITB in the gym. Let me tell you: you cannot release your IT band with a foam roller. Whilst a foam roller is an amazing tool that can be used to release muscle tightness all over your body, the IT band is not one of them. Because the IT band is very strong connective tissue and not muscle, you would require far more pressure than you could generate with a foam roller to make the necessary impact.
Foam rolling the gluteus maximus and the TFL muscle to ease IT band tightness
The clue with treatment is finding out what is moving well in the body and what is not moving well. Foam rolling your glutes and TFL muscle can be a good start (find out how to do this correctly here ), but a proper assessment of the biomechanics at play is needed to address the underlying cause of your pain.
At Physio K, we are experienced in finding and addressing the root cause of your problem and guiding you in your rehab, so you can get back to doing what you love.
To book an appointment with one of our experienced practitioners: click here