IT Band Syndrome: Common Misconceptions and Treatment Solutions!

What is the IT Band?

The IT band (iliotibial band) runs along the outer leg and travels from the hip to the knee. The problem is often called IT Band Syndrome, but this does not give us any information why it occurs. Most people self treat with foam rollers and other soft tissue work on this area with little relief. Why are they unsuccessful? They are not addressing the CAUSE of the problem, but only treating a single impairment. 

When does IT Band tightness typically occur?
Tightness along the outer leg is commonly felt after running, doing squats, going up stairs, or basically all the time if you're my wife!

Why does IT Band tightness occur?
1)Weakness of the outer hip muscles and gluteals
2) Weakness of the calf muscles
3) Poor hip external rotation mobility
4) Poor control of the abdominal muscles

Read about knee pain

Knee Pain Self Management

The IT Band does NOT stretch! Foam Rollers and side stretches are NOT permanent solutions! 

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How to Treat IT Band Syndrome

Side plank clamshells
This exercise targets the outer hip muscles, known as the hip abductors. These muscles are really important for stabilizing the hips and keeping them level. Adding the side plank targets the internal and external obliques as well. 

How does it prevent IT band tightness?
The IT band attaches to a hip flexor muscle (tensor fascia latae muscle) on the front of the hip. This hip flexor also turns the leg inward (imagine the movement of the knees collapsing together). In many people, the tensor fascia latae works really hard (i.e lots of knee collapse). Consequently, the gluteal muscles in the back stop doing their job. The clamshell specifically targets the outer gluteal while turning off the front hip flexor (research has proven it!). Strong gluteals + Minimizing tensor fascia latae muscle activation = less IT band tightness!

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Hip Kicks in a Hover Plank
Hip kicks (similar to the bird dog exercise) are great for strengthening the gluteal muscles, specifically the gluteus maximus. This powerful muscle helps stabilize the knee and low back! Adding the hover plank targets the core muscles to a greater demand as well.

How does it prevent IT band tightness?
Many people with IT band tension have trouble isolating their core muscles from their legs. For example, they may have increased trunk sway while running. The plank keeps the spine in neutral while moving the lower body. This movement teaches the trunk to remain stable while the legs alternate.

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Hip Clocks
​The hip joint is built for mobility. Unfortunately, most people sit to much and move to little. Hip clocks are a Heafner Health favorite because they target both hip internal and external rotation.

How does it prevent IT band tightness?
The hip joint and surrounding muscles contain tons of small receptors that communicate with the brain. These receptors are a key component of muscle memory. When the hip loses rotation, the small receptors become less sensitive and communicate less with the brain. This leads to overall less awareness and perception of the hip joint and decreased ability to target specific muscles.

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Single Leg Bridge
Research has shown the single leg bridge to be a good glute strengthening exercise. ATTENTION: it is easy to cheat this movement by using the low back or hamstrings! Heafner Health recommends to start with a smaller lift and be sure the hips drive the movement.

How does it prevent IT band tightness?
​Glutes, glutes, glutes! Stronger muscles on the back of the body will keep the trunk upright and in good alignment. Additionally, the bridge opens up the front of the hip joint and provides a stretch to the hip flexors. 

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Hip Flexor Stretch 
The IT band does not stretch! Seriously, it is impossible. It can withstand THOUSANDS of pounds of strain. However, tissue around the IT band does get tight and needs mobility work. The hip flexor stretch opens the front of the hip and allows for better mobility of the hip. The added side bend increases the tension across the outer hip muscles.

How does it prevent IT band tightness?
As mentioned on Day 1, the hip flexors work hard and often become shortened. When shortened, they do not allow the leg to fully extend backward. For example, a runner trying to take a full stride may be limited by tension in the front of the hips. Since the IT band attaches to the hip flexors, the tension translates down the outer leg and can cause knee pain.

Movement is the Key to Longevity! 

-Dr. Jim Heafner PT, DPT, OCS

Stop by Heafner Health!

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Check out Dr. Jim Heafner's first book: The Yoga Fix

The Yoga Fix deconstructs the common misalignments that occur in a standard yoga practice. This book combines the physical therapy & movement expertise of Dr. Heafner with the skillfulness of yoga teacher Keith Allen. The Yoga Fix takes readers through 40+ poses, identifying both the Eastern and Western approaches to the practice. ​

​Read more at www.theyogafixbook.com