IT Band Syndrome is a common cause of pain on the outside of the knee and is more commonly seen in runners. The IT Band is a strong, thick band of fibrous tissue with direct proximal attachments to the TFL, Glute Minimus, Glute Medius, and Glute Max. It runs along the lateral quad, and attaches on the lateral side of the tibia.
The IT band acts primarily as a stabilizer during running and may become irritated from overuse. In clinical practice, I have found the most common cause of IT Band Syndrome to be faulty running mechanics associated with a lateral chain weakness.
Although the current treatment remedies such as foam rolling, stretching, ice, NSAID’s are helpful in reducing symptoms, they do very little to improve the biomechanical deficiencies that cause the problem. In my previous post, I discussed the importance of glute medius strengthening to improve pelvic alignment. It’s important to understand that long term correction of IT Band Syndrome requires a comprehensive approach. Techniques such as Active Release Technique and Graston are great for relieving symptoms, but in my experience, if faulty running mechanics are not addressed, the symptoms will return as athletes increase their mileage.
The biomechanical abnormalities that may lead to IT band problems include excessive pronation of the foot, leg length discrepancy, and pelvic unleveling. Muscle tightness or lack of flexibility in the glutes or quad muscles may increase the risk of IT band injuries.
The above depiction of pelvic unleveling reveals compensatory changes to include adduction and internal rotation of the knee and over pronation of the foot. These compensatory changes can be a major contributor to IT Band issues. As a result of the pelvic unleveling on the left, you can see how the IT Band and hip musculature may be over stretched on the right side as they try to stabilize and prevent lateral drift to the right. A comprehensive approach to include pelvic alignment utilizing manipulation or Muscle Energy Technique, Active Release and/or Graston to work the tight overactive tissues, and corrective exercise to address the lateral chain weakness are required for long term correction of the problem.
Active Release Technique is a patented, non-invasive, soft-tissue treatment process that both locates and breaks down the scar tissue and fibrotic adhesions, which cause pain, stiffness, decreased range of motion, numbness, and physical dysfunction associated with Repetitive Strain Injuries (RSI). ART is used both for the treatment of RSI’s, as well as the improvement of athletic performance.