I was asked about IT (iliotibial) Band Syndrome by a fan of Rehab and Revive who had been running five miles a day, four times a week on a very regular basis. He had recently increased the distance to seven miles and complained of IT band inflammation and pain at about the five-mile mark since the change. He had several questions regarding his pain and how to get out of it:
Are there any recommended stretches for IT band pain?
If so, what type of stretches?
Do you have to stay off of it/rest for it to heal?
If so, how long?
Before we get into answering his questions, it's important to understand what the IT band is. So here's our daily anatomy and physiology lesson:
The IT band is located on the side of the thigh. It is a tight collection of connective tissues that can cause pain in the knee, side of the hip, or the side of the thigh. It is mostly a nuisance for many and it is unlikely that anyone would be disabled from this injury. However, that doesn't mean it can't be extremely painful when irritated. Runners and other kinds of athletes develop this pain more often. However, I've seen patients who drive or sit all day who have ITBS as a secondary symptom to their lower back or knee pain.
It band issues can be caused by many things. Commonly, ITBS stems from weaker core muscles, lateral buttocks muscles, and, likely, a short stride length when running.
Now, let's answer some of those above questions!
The most important thing to do if you think you have ITBS is to seek a professional's diagnosis. A well-trained eye is needed to see the changes in stride and mechanics (especially for the gentleman above who fatigues at mile five). If mechanics are not addressed it really doesn't matter what and how he strengthens and stretches. He will always have to fight a battle with IT band pain.
But if you find yourself struggling with IT band pain and irritation, here are some of my general recommendations:
1. CHANGE YOUR SHOES! IF you have worn the same running shoes for more than 6 months this could be a huge contributing factor. The shoe may not show wear on the outside, but due to compression or pressure on the material on the inside, the support and composition of the shoes may be greatly diminished!
2. If you're really concerned about your IT band pain, it might be worth it to get fitted for custom orthotics. The foot mechanics are instrumental in influencing the hip and knee mechanics.
3. You can also give some exercises and stretches a try. Remember no one exercise routine works for everyone, so it's best to consult a professional before adding an exercise to your workout. But these are the exercises and stretches I give most commonly to my patients that suffer from IT band pain.
Lateral Step Ups- this exercise increases lateral buttock strength
Later Walking- this also increases lateral buttock strength
Foam Rolling the IT Band- This is good to loosen up the tighter connective tissues around the muscles. If these muscles are too tight, the mechanics are all thrown off.
Hip Flexor Stretching- this helps increase hip and knee extension in the walking cycle
Planks- to help increase core strength
The true key is to seek a physical therapist who can firmly diagnose the exact cause of the problem is. They can make recommendations to ensure there aren't other things going on to cause the ITBS such as pelvic misalignment. If you're experiencing symptoms of ITBS, have someone check it out as soon as possible so that you can seek the best form of treatment for you!
Wishing you all health, especially during this time,
Dr. Justin C. Lin
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