The Great Illiotibial Band Mystery

Raise your hand if you’ve ever had Illiotibial Band Syndrome.

*Hand up*

That mysterious pain on the outside of your knee or hip that hurts more the more you run? That’s the one. If you’ve been a runner for more than a month, you’ve probably come across some IT Band problems. It’s such a common issue for runners that it gets its own post!

Hello, little band. You are a big pain in the butt.

There are a couple of things to understand about the IT Band:

  1. It’s fascia, not a muscle.
  2. Its origin (upper attachment) is on the muscle belly of the Tensor Fascia Lata (which attaches to the hip) and the iliac crest and girdle (hip).
  3. Its insertion (lower attachment) is to the femur (thigh), the patella (knee) and the tibia (shin).
  4. In a cadaver, the fascia is about as thick as tissue paper but wicked-strong.

Because the attachment sights are at the hip and the knee/shin area, the wider your hips are, (or more knocked-kneed you are) the more prone to IT Band problems you will be. This is why women experience more cases of IT Band syndrome than men. Yet another awesome anatomic anomaly in favor of the fairer sex. Yay.

Essentially, it is the job of this fascia to stabilize both the knee and hip. It is tense in both extension and flexion of the knee (when you bend and straighten it = all the time) and it is also involved in hip abduction (moving your leg out to the side). What does this mean for runners? Well, it’s always working. In every direction. For the whole run.

Ergo, without proper training it gets pooped out easily.

Why IT Band Syndrome happens:

  1. Your hips/glutes are weak.
  2. You add too much mileage or speed too soon.
  3. Your shoes suck.
  4. Your gait is wonky.

These problems are easily fixed by the following methods:

  1. Hip/Glute strengthening exercises.
  2. Stretching (live in half-pigeon for a while).
  3. Only add 10-15% more mileage every week (and cut back if you have pain).
  4. Foam roll your hips and glutes.

See? The IT Band isn’t so scary now that you know what to do with it! You should really be doing all of this anyway to prevent IT Band (and other) injuries so get on it! If your pain persists after implementing these tips, lay off the running and see and orthopedist to make sure it’s not something more serious.

Happy trails!

Now go out and run.

Exercises To Do This Week: STRONGER HIPS

Question:

Why can’t I lift my knees higher when I run?

Why does it ache on the outside of my hip?

Why does my IT band flare up all the time?

Why can’t I stride longer?

Why is my foot turnover slow?

Why does it hurt across the top of my butt?

Why do I trip over my toes when I run/walk?

Answer: Your hips are weak.

A little anatomy lesson:

The hip joint is the largest joint of your body. The anatomy of the front of the hip joint looks like this:

Image from Wikipedia

The psoas major and illiacus form the iliopsoas tendon that crosses from the abdominal cavity into the lower extremity (your quadricep area). This tendon is responsible for lifting both a straight leg and bent knee forward.

The tensor fascia lata (TFL) is the muscle belly for the dreaded Illiotibial band/tract (IT band) that steadies the hip laterally as you put pressure on your legs in the form of walking and running. It’s a hip stabilizer. Without it, the hip would pop out of the socket.

The anatomy of the rear (and most internal) part of the hip looks like this:

Image from Wikipedia

These are the hip rotators, responsible for rotating (duh) and stabilizing the hip joint.

Image from Wikipedia

The gluteus maximus (largest muscle in your rear) is the powerhouse of pushing (think sitting down and standing up) and the gluteus medius is responsible for abduction (lifting your leg to the side), rotation and stabilization of the hip.

What does this mean to you? In short, these muscles are your problem. If you’re a female, they are usually a very big problem because female hip girdles are much wider than that of men and the angle from our hip to our knee is more severe. Big problem.

These muscles stabilize your hip joint as you run and walk. Because running and walking has forward motion and rarely has lateral movement, these are the secondary muscles that keep your hip in place as you push off and catch yourself. Because they are secondary, they are often ignored in a typical strength training routine. Running and walking is choreographed falling and these muscles keep your hip from falling right out of its socket. If you swim, bike, do yoga or dance, they are the muscles that help you kick and push and pull your legs. Pretty important, right?

They are so important that most people pay absolutely no attention to them at all until they hurt like hell. Why? It’s just lack of knowledge. But you’re a smart runner. You seek knowledge before there’s a problem. That’s why you’re here.

When these muscles are ignored, you can end up with tendonitis, ITB syndrome, TFL problems, meniscus tears, lower back pain, muscle strains everywhere from your hips to your calves and a whole host of other problems. All because you’re missing three simple exercises from your weekly workouts. No longer.

#1. Leg Lift: for the iliopsoas (the one that lifts your leg and your knee)

-Lie flat on your back with a light ankle weight around your straight leg.

-Keep your toes pointed toward the sky and lift your straight leg up and down for one minute with out stopping.

#2. Abductor Leg Lift: for the hip rotators and gluteus medius

-Lie directly on your side with one arm tucked under your head and the other in front of your belly button for balance. Legs straight, one on top of the other.

-Lift your top straight leg up to just past hip height. Keep all of your toes facing forward (don’t turn them up toward the ceiling) and lower the leg back down. 1 minute without stopping.

#3. Rear Leg Lift: for gluteus maximus (big butt muscle)

-Lie on your stomach with your hands under your forehead, forehead on the ground. Legs straight, toes slightly lower than your body (see how LB’s toes are off the mat?)

-Squeeze your butt (very important!) and lift your straight leg up a few inches (no higher) and then back down, but don’t lose the feeling of squeezing your butt. The more you squeeze, the more you work.

Every single athlete, heck, PERSON in the world should be doing these exercises. They help prevent and rehabilitate the most common injuries that sideline runners by strengthen those tiny, but vitally important, muscles of the hip. This is the largest joint of the body (I know I said that already, but IT IS), so show it some love. My Radio City Rockette has learned to love these exercises and so should you! Do each of these exercises for one minute twice a week and you will be amazed at how it helps make you a better, stronger runner. I promise.

Now go out and run!