Monday, July 16, 2007

Ilotibial Band Problems

What in the heck is it? The Ilotibial band or IT band as I will refer to it going forward is a long flat tendon (apneurosis) that originates at gluteus maximus and tensor fascialata (TFL) and inserts on the side of the knee. Glute max extends and abducts the leg. It is involved in every step we take. TFL is a hip flexor that is also involved in every step. It would only make sense that these two muscles might be subject to overuse especially if you are an athlete. So what is overuse? It is different for everyone. If you are very flexible and stretch regularly, over use is not as likely. If you are inflexible and seldom stretch, overuse is in your "near future". When overuse occurs, it involves glute max most frequently. The muscle tightens and thus pulls the IT band upward causing a pull at the side of the knee. It feels like the tendon is trying to pull away from the side of the knee. It burns and aches and certainly will make life miserable.

Another cause that I have found to manifest symptoms in the IT band is knots on the outside of the quadricep muscle (vastus lateralis) under the IT band. These knots can be large enough that they stretch the IT band causing symptoms. This is the easier of the causes to eliminate. It involves deep tissue work that can be painful (albeit temporary). It will make you want to use some choice language. However, symptoms can be eliminated almost immediately often times. I'll share a success story. I had a client that was doing a marathon in two days and unable to run at all the pain was so bad. He scheduled a massage with me. Ordinarily, I would never do deep work on someone that was doing an event in two days unless they were regular massage recipients. I explained to the client that the deep work would either drastically improve his chance of running or not. The second option already existed so he said "go for it". I went into vastus lateralis and worked out the knots on the side of his quad that were below the IT band. I happened to be working an aid station at the marathon and I never saw him during the race. I was affraid that I had crippled him. The following Monday I received an e mail from him thanking me. He said that he not only was able to run the entire marathon, he finished one hour faster that any previous marathon.

How do you avoid IT band problems. The first choice is to stay flexible. Stretch glutes and TFL after every workout. Check out the links on my blog for some stretching suggestions or contact me to learn about some options.

One of the most important things that I can share with you is when you start symptoms of IT band problems take action immediately. If you try to run or cycle through it, you are flirting with "long term layoff". Of course that is one of the most feared phrases in an athletes life.

Stretch, hydrate and call me if you need me. 615-596-2564.

1 comment:

Stephanie said...

What kind of choice language are you talking about? I need an example.