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How Can I Relieve IT Band Pain?

Posted by: on November, 3 2015

Found on RunnersWorld.com and written by William O. Roberts MD

IT Band Syndrome is commonly caused by lack of strength.


I’ve been struggling with IT Band Syndrome since 2005 when I started training for the Big Sur marathon in 2006. It got so bad at mile 18 that I had walk most of the way. After the marathon, it came and went when I ran. There would be periods when it was fine then there would be periods when it hurt (like the tendon was being flicked at). Now, it is at the point where it hurts every time I try to run. I’ve taken long and many rest periods where I just say I won’t run anymore. I understand that seeing a professional is needed but what can I do?it band

Dear Rachel,

The iliotibial band (ITB) is the lower portion of the tensor fasciae latae (TFL) extending from its origin on the iliac crest and extending down the lateral thigh to insertion the lateral tibial plateau below the joint line of the knee. The fasciae latae connects with other muscle fascia (glutes) in the buttocks and thigh to form a web that tightens like a Chinese finger trap when the TFL contracts. The TFL contracts when the opposite foot is off the ground to help stabilize the knee and hip/pelvis by tightening the fasciae latae and the ITB. In its path, the ITB courses over the lateral femoral condyle and if the ITB is too tight or the mechanics are off, it irritates the underlying tissue causing pain.

The fasciae latae and the ITB have been dissected and tested to determine the load that will stretch the tissue. While you can likely stretch the muscle tissue at the top of the pelvis, the fascia tissue is too strong to stretch within normal physiologic loads. Therefore, the stretching plans to relieve ITB syndrome are generally ineffective and the mechanics around the femoral condyle are likely to blame for causing the syndrome rather than the tissue being “too tight.”

If the femoral condyle/ITB interface is the victim, then the likely culprit is inadequate strength in the external rotators and/or adductors of the hip or abnormal rotation of the pelvis through the sacroiliac (SI) joint. You can work on glute, adductor, and external rotator strength on your own and see if that helps your return to running.

You might also consider an evaluation by a provider who can assess your lower extremity, pelvis, and back mechanics; and if indicated, correct the problems with manual therapy or strengthening exercises, or both.

I hope this helps.