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All About the IT Band
You’ll likely come across some explanations about iliotibial (IT) band syndrome or people advising different stretches and foam rolling.
If you did a quick google search of ‘IT band syndrome,’ you may see that it can cause several problems ranging from hip pain, thigh pain, and even knee pain.
But what really is the IT band? What is IT band syndrome?
What is the IT Band?
The IT band is unique from other supportive structures in our body because it stabilizes our knees and hips during movement.
Did You Know
Unlike most fibrous tissues of the same composition, it extends down the outside of the thigh – running from the top of the pelvis (iliac crest) to the outside of the knee (on the tibia).
Important muscles that assist with hip movement, portions of the gluteus maximus, medius, minimus, and the tensor fascia lata (TFL), are attached to the IT band near the hip.
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While these muscles all help move the hip in, out, front, and back, the IT band is hard at work, providing crucial support to the outer knee.
To do this, the IT band moves with the knee when it is bent and when it is straightened.
As the knee goes from bent to straight, the IT band shifts forward.
As the knee goes from straight to bent, the IT band shifts backward.
It is essential to keep in mind that the IT band is not like other soft tissues in the body.
Unlike a supportive and relatively immobile ligament, the IT band is very mobile due to its location and attachments to essential muscles.
However, it is also more stable than a muscle due to its dense composition of fibrous connective tissue.
This fascia is stronger than most because of its arrangement into long thick bands, allowing it to maintain elastic properties, absorbing and recycling the forces of the lower extremities.
For these reasons, it is easy to see that the IT band plays a significant biomechanical role in our daily activities, like walking and bending down.
How Does the IT Band Work?
A normal biomechanically sound gait pattern will properly use the muscles that attach to the IT band, the gluteal muscles, and the TFL.
As previously mentioned, these muscles contract and stabilize the pelvis during movement, producing forces that extend through the IT band.
When the body’s weight falls onto one leg, the hip muscles activate to support the pelvis.
Similar to how bone remodels after being placed under stress, the connective tissue in the IT band thickens over time to withstand this repeated stress that naturally occurs.(1)
What is IT Band Syndrome?
Signs and Symptoms
IT band syndrome falls into the category of overuse injuries.
This means it can happen over time with poor biomechanical patterns – not from one specific event.
While it can happen to anyone, it is more common in athletes.
The most conventional presentations of IT band syndrome include pain at the outside of the hip or the outside of the knee.
Some patients will note a ‘snapping’ type of pain which is thought to be related to the movement of the IT band during daily motions.
It’s possible to have swelling at either end of the IT band, though it is more common at the knee.
IT Band Myths
Like most commonly occurring overuse injuries in the musculoskeletal system, there is a host of misinformation on the internet about IT band syndrome.
We want to shed some light on some of the most common myths about IT band syndrome.
Myth #1: The IT Band Gets Tight and Can Be Stretched.
We can reason through this by using some of the above-described concepts.
We know that the IT band is not muscle, but rather it is made of dense connective tissue and has attachments to muscles.
Therefore, the IT band itself cannot tighten, but the muscles it attaches to can.
When these muscles become tense, they can cause more strain on the IT band.
This means that stretching the IT band itself is very difficult because of the orientation and composition of the fascia.
One study has even shown that only small changes in the length were measured through extremely forceful stretching attempts of the IT bands in cadavers! (2)
It can stand to reason that stretching should instead focus on the tight muscles that a healthcare professional has determined contribute to the problem.
Myth #2: Foam Rolling Can Treat IT Band Syndrome.
Now we know that stretching the IT band is largely ineffective, but what about foam rolling?
Many people will argue that foam rolling can apply more pressure to the IT band than stretching alone, overcoming the usual significant forces needed to elicit a stretch response.
However, this pressure is often misdirected and can compress the soft tissues beneath the IT band before potentially benefiting the IT band itself.
Despite its growing popularity, research into the effects of using a foam roller for IT band syndrome has revealed little evidence to support its use for alleviating pain and improving function. (3)
Rather than utilizing a foam roller for reducing pain from IT band syndrome, high-quality treatment should concentrate on treating the root cause of the problem.
What Causes IT Band Syndrome?
Now you might be wondering, ‘what exactly does cause IT band syndrome?’.
This is a loaded question, and the answer itself may be unsatisfying.
IT band syndrome can be caused by gait imbalances and poor posture habits, which means several things for many people.
For a serious athlete, this can mean they’ve adopted inefficient training habits.
For the weekend warrior, this can mean not maintaining the flexibility of their muscles, and for the average joe, it could mean there is another mechanical imbalance present in the lumbar spine, pelvis, hips, or knees.
The primary cause of IT band syndrome is overuse, so diagnosis relies heavily on the patient’s having a thorough history and complete physical exam.
That’s why it’s important to check with a healthcare professional before ever referring to Dr. Google to answer your questions or self-diagnose.
Can a Chiropractor Help?
In short – yes!
A chiropractor receives years of education on identifying poor movement patterns that may be causing overuse injuries, like IT band syndrome.
Chiropractors know that pain is a symptom of a more significant problem, and they are trained to both treat your symptoms and help find the cause.
We’ve put together an awesome list of exercises for you to get started or use as a reference.