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The IT Band, Explained

Updated May 2019

If running is your passion, you may find yourself running into Ilitotibial Band Syndrome (ITBS) if you aren’t careful. Your IT band is crucial to pain-free movement, so keeping it healthy keeps you running toward your goals—literally! Here are the four most commonly asked questions I get about ITBS:

Question #1: What is an Iliotibial Band (ITB)?

The IT band is a strong band of connective tissue that runs from the top of the pelvis down the outside of the leg, inserting into the lateral tibial condyle just below the outside of the knee.

It functions to help the muscles of the leg create movement and stabilize the knee during walking and running.

Diagram of leg muscles.

Question #2: What is Iliotibial Band Syndrome (ITBS)?

ITBS is the presence of pain and inflammation at the outside of the knee, due to friction created by the backward and forward motion of the ITB over the femoral condyle as the knee bends and straightens, respectively. Pain is often worse with running downhill.

Diagram of IT band.

Question #3: What causes ITBS?

There are several potential causes of ITBS. First, decreased flexibility of the ITB itself or the muscles around the hip and knee can lead to increased tension on the ITB (creating more friction).

Second, muscle weakness, particularly weak hip abductors, can force other muscles to take on more work which also creates more tension through the ITB.

Third, a sudden change in training routine can contribute to ITBS. This can include changes in distance, speed, terrain, or footwear.

Finally, certain biomechanics or running styles can contribute to the development of ITBS.

Question #4: How can I treat ITBS?

It is important to first identify which of the above factors may be contributing to your pain. Physiotherapists are a great resource for assessing these factors and working with you to come up with a treatment plan based on their findings.

Some common avenues for treatment begin with rest, taping, ice, massage and stretching of tight muscles, and strengthening exercises for weaker muscles. Biomechanical assessment and treatment may also be important to increase control and correct movement patterns during running which may be placing more stress on the ITB.

When it comes time to begin returning to running, the most important factor is that this process is gradual. Early in this process, we often educate our athletes on deep water running. Deep water running can be a great way to increase cardiovascular fitness in a sport-specific manner. The following video shows an example:

Illustration of figure running.

Riley Bay began her undergraduate studies in Victoria and graduated with a degree in psychology. She then completed her Masters of Physical Therapy at the University of British Columbia. Riley has gained further training in manual therapy techniques including Mulligan's Mobilization with Movement and The McKenzie Method. Through a combination of individualized therapeutic exercise, hands on manual therapy, and education, Riley is passionate about working together with her patients to help facilitate their return to the sports and activities that are important to them. Book with Riley today.

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