What You Don’t Know About the Iliotibial (IT) Band

  • February 12, 2018

A lot is believed and said about Iliotibial Band (IT Band) injuries, but are they all true? As with many issues or injuries, we cannot always trust “internet doctors.”

Lets begin with just what is the Iliotibial Band?

The IT band is a thick band of fibrous tissue that runs from the outside aspect of your pelvis and inserts just below the outside of your knee joint. This “band” of tissue serves to “support or stabilize” the knee relative to the pelvis with walking/running.

Can the Iliotibial Band be stretched?

This is highly debated by folks on both sides. Generally we think about stretching muscles, which the IT band is NOT. It is connective tissue, which has the potential to be stretched, HOWEVER, this is not an easy thing to do (though some will claim otherwise). To begin with, will you really be stretching the IT band (connective tissue) or the muscles from which is attaches (mainly the TFL and some gluteal fibers)?

In my prior running life, I was told and believed that it could be stretched. I thought maybe it was stretching or at least something was. I would do foam rolling (which maybe helped). Everything seemed to help but it always “tight” and the issue would periodically resurface. If it was being stretched multiple times per day shouldn’t the tightness go away? Something was missing. Fast forward through advanced schooling in anatomy, biomechanics, and rehabilitative sciences and I reached the conclusion that it was not really the IT band that was being stretched. There was another piece at play here necessary to treat (more on this to come).

BUT if one is to “stretch” the IT band, how would one do this?

Well…here are 3 ways many individuals tend to use…

                                    

If stretching isn’t the answer, what is?

From a simplified standpoint…strengthening (of the Hip or feet). But the pain is at my knee, how will strengthening the hip or feet really help? Well…time for anatomy and biomechanics. The IT band forms off the TFL and some gluteal fibers. In many individuals, the TFL is “overworked” relative to the gluteal muscles. This leads to increased tension migrating down to the IT band. PLUS, if the gluteal muscles are not doing their job well enough, then increased strain to the TFL and IT band will result (especially in runners) and there is your pain. Probably the #1 thing to do for an IT band problem is strength your gluteals (butt) See HERE, HERE, and HERE

Secondly, everyone wants to talk about “pronation” as if it is a bad thing. Pronation happens with every single step you take – it is normal. There are those out there who will paint “over- pronation” as the root of all issues. And I will admit there is some truth that pronation might be an issue for some but not all. And working to improve foot strength (HERE or HERE) and mechanics (sometimes via orthotics or shoes) is helpful.

Bottom line?

IT band problems are common in runners and even in non-athletes. Treatment is highly successful once the most likely source is discovered and addressed. These issues while annoying and possibly painful do not have to stop you from being active. More questions- I’ve got more answers for you…

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