How to give your ITB some TLC…

Edit May 2013: I’ve just written a follow up post where I walk you through the exact steps I use to help fix an ITB problem. Click here to read it. Thanks for visiting!

I.T.B.

These 3 (seemingly) innocuous letters strike fear into the heart of anyone who has suffered from iliotibial band syndrome. ITBS seems to sneak up on us when we least expect it and often at a key stage in our preparation for an event.

My ITB & I have had a love/hate relationship for many years. We still do. It is something I manage almost on a daily basis. And even with everything I have done over the years to keep it happy, it is still quick to remind me when I have been neglecting the basics.

I have tried various treatments over the years & thought I would share with you two things that have worked for me.

But first a bit of background -

What is your ITB?

The ITB is a wide, flat tendon which runs from your hip down the side of your leg and attaches into the side of your lower leg, just below the level of your kneecap.

It basically acts like a strut. It provides stability to your leg and prevents excess lateral (or sideways) movement of your leg and knee.

When it becomes tight, it can rub on the bony points in your knee (most commonly) or in your hip & ITBS is born. The tighter it becomes, the more pain you get.

Surgical removal of your ITB apparently isn’t an option. I’ve asked

What causes ITBS?

ITB syndrome (ITBS) is commonly caused by tight and/or weak glute muscles (ie, your butt).

When these muscles get weak, they don’t do the work they are designed to. So other muscles & tendons need to ‘pick up the slack’ and end up functioning in a way they were not designed to. The result is that these muscles & tendons get overused and become tight which can result in discomfort, pain and ultimately injury.

So how do I manage ITBS?

I have listed below the most effective ways I have found to address and manage your ITB.

They work for me. They may not work for you.

There are others methods which did not work for me – such as a cortisol injection – but I know of others who have found it to be successful.

(1) Use a foam roller on parts of your body other than just your ITB

Much of what is written about ITBS focuses on stretching and rolling your ITB. That is, of course, part of the equation. But what worked for me is to focus on what happens in the rest of my body.

Try using a foam roller on your adductors to start with. I have found this to be more effective than using a foam roller directly onto your ITB.

When your adductors – the muscles which run down the inside of your leg from your pelvis to your knees – become overactive or tight, they effectively pull your leg closer to the midline of your body. As this happens, your ITB also gets pulled and stretched even further.

So returning your adductors to their normal length & position is crucial to releasing the pressure on your ITB.

This is why I (personally) struggle to support the (common) view that stretching your ITB is always a good idea. If your adductors are tight, your ITB will be already in a stretched position. Why stretch youit even further?

Now one word of warning – using a foam roller on your adductors isn’t going to tickle. In fact, it will probably hurt. A lot. BUT it is worth it.

Also try rolling your quadriceps, particularly the side of quads where it joins your ITB. Start with the foam roller near your knees and roll it slowly up your body towards your hip.

We tend to keep a lot of tension and stress in our quadriceps due to everyday activities such as sitting for long periods of time so it can be very tender.

Using a foam roller on your calves, and the outside of them in particular, can also help to relieve the pressure. If you can get your calf to relax , it can also help to ease the pressure on your ITB.

Check out our post on self myofascial release here for the specific technique to use when using a foam roller.

(2) Don’t stop doing your exercises!

Otherwise you will miss out on one of the most important phases in your recovery.

Physiotherapists will initially prescribe certain basic exercises such as clams in order to ‘wake up’ & activate the lazy or weak muscles in your butt. These (isolated) exercises tend to be done in a very stable environment, eg. laying on the floor. Eventually you will become strong enough to do more difficult & challenging exercises as your butt gets stronger.

However by the time most people are able to do more difficult & challenging exercises with good form, the symptoms of ITBS (ie, the pain & discomfort) tends to fade and/or disappear. Hands up if you have stopped seeing your physio at this point? You aren’t alone; most people do.

But you miss out on one of the most important phases in your recovery – making the transition from isolated exercises (like the clam) done in a stable environment to exercises which teach, & require, your glutes to work in a dynamic unstable environment which sport & everday life requires.

Think about it – you are laying on the floor doing your clam exercises. Does your sport require that specific movement? How many times each day do you move in a way that replicates the clam movement? Keep that answer to yourself

My point is that having glutes which are strong enough to perform the clam is only one step on the road to recovery. It does not necessarily translate to having a butt which works properly when you get up out of your chair, propel yourself forward when running or push down on the pedal when riding.

So either -

(1) stick with the physiotherapist prescribed exercises even after the discomfort or pain has disappeared and/or

(2) find a personal trainer who can help you make the transition from isolated exercises to whole body, movement based exercises which reflect the way your body needs to move in sport and life!

As most people have weak glutes, in the next few weeks I will explore some glute activation exercises which you can do at home.

In the meantime, please share with me –

• your experience with ITBS;
• what treatment options you tried;
• which ones worked? Which ones didn’t?

Thanks for dropping by !