Iliotibial Band Syndrome (ITBS): Anatomy, Causes, Signs & Symptoms and Treatment – Vidpt

Iliotibial Band Syndrome (ITBS): Anatomy, Causes, Signs & Symptoms and Treatment – Vidpt


Welcome to VidPT (https://vidpt.com) Today we are going to discuss IT band syndrome. That’s right, iliotibial band syndrome. Which is the most common cause of lateral knee pain in runners. We will start with some basic anatomy Discuss some common signs and symptoms associated the IT band syndrome and conclude with how to strengthen key areas of the body to combat it Now, IT band syndrome is a very common overuse or wear and tear injury It typically targets runners cyclists CrossFitters and other athletes that squat often The IT band tends to get overworked as a result of muscle imbalances or potential muscle deficiencies in the body Consequently, you get pain on the outside part of the hip you can get myofascial restrictions all along the outer part of the leg and you can experience sharp pain on the outside part of the knee where The IT band rubs over the femoral epicondyle The primary function of the IT band and its associated muscles to extend abduct, and laterally rotate the hip. Additionally, the IT band contributes to lateral knee stabilization by connecting the muscles of the hip to the tibia of the lower leg In terms of anatomy the IT band starts up at the hip Up here you have what’s called the iliac crest. Off of the iliac crest you have a short strap like muscle It’s called the TFL. The IT band runs off the TFL it gets a contribution from the gluteus maximus And then it runs down the length of the thigh, it runs down the iliotibial tract or the IT band. Right, so just look at this stripe. It goes down the stripe all the way Crosses over the knee joint, the outside part of the knee, across the lateral femoral epicondyle and then inserts itself down below Onto the anterior side of the tibia So another way to think of the IT band. It’s a continuation of the tendinous portion The TFL (tensor fascia latae) and there is a contribution, a small contribution from the gluteus maximus. Alright, so we’re about to go in the weeds, and I promise there is a key takeaway. So this iliotibial tract right runs down the length of the thigh is Classified as deep fascia There are all different types of fascia in the body In general, fascia is terribly important and is incredibly fascinating since it surrounds and connects muscles of the body to other tissues. This fascia is comprised or classified as deep fascia. It’s composed of very strong connective tissue. This tissue is primarily composed of collagen and fibroblast cells There are a few elastin fibers in there But it’s very strong and as many of you know Collagen is one of the strongest proteins you can find in nature, and it is one of the strongest structures in the human body Consequently, the IT band is strong, it’s tough, and it’s relatively inelastic So what does this mean? Well, it impacts your stretching routine. Many physical therapists and trainers promote stretching the IT band. In practice it’s incredibly difficult to do so just based on the sheer composition of the IT band Consequently, I found it’s much more effective to stretch the surrounding areas. You stretch your glutes It’s good to get in your glutes, you get into the hips, you stretch your hamstrings You can stretch the outer part of your thigh, you can stretch your calves. Additionally, you can get into your hip flexors and psoas. For you stretching masochists out there. There are some of you that absolutely love the foam roller. Here’s a substitute this This is a tennis ball. You can go to town where the tennis ball right you lie on your back You can get into your gluteus maximus. You can get into the medius It’s really hard to get into the gluteus minimus since it goes under the other structures, but you can get into your glutes You can get in your hips, you can get into the TfL Right you can really start to loosen a lot of the lateral gluteal muscles If you want to get into the hip flexors and psoas I recommend a larger, softer ball Okay, this doesn’t have a lot of give so use a larger softer ball when you’re lying on your front But the tennis ball is terrific you can get in a lot of places and get some of the strain and tension out of there and help the IT band move more freely and to have less pain. For you runners out there It’s really important to stretch your calves as well, so I mentioned stretching your calves But there’s two main muscles right you have the gastrocnemius And you have the soleus You need to stretch both. If you’re already having pain on the outside part of the knee And you have tight calves it can lead to greater pronation when you run. It changes the way your foot strikes the ground Right, the way you’re putting energy into the ground, the way It’s coming back and it can increase knee flexion So if you have greater knee flexion you’re going to exacerbate the pain on the outside part of your knee. So what are some common signs and symptoms associated with IT band syndrome? Most people get pain on the outside part of the knee Typically it starts as kind of a needle prick. I’ve had it several times It’s where you get needle pricks and outside part of the knee You continue to heal strike, you go up and down stairs, you carry heavy things Then it moves up the leg and you get myofascial restrictions And then it goes into the hip. So when it’s onset it’s really typically the knee and the hip So how do we fix it? Right, that’s why you’re here today. How do we fix IT band syndrome? Research studies out of Stanford University have shown the IT band syndrome is Correlated or attributable to weakness in the hips and glutes Your glutes are comprised of three key muscles. You have the gluteus maximus, which everyone loves to talk about, you have the medius and minimus the medius and minimus are primarily responsible for balance and when you run or cycle you need to have good balance and proper body mechanics. If you’re weak in the hips and glutes your body will compensate. Your body is amazing at compensating. So if you’re weak in the gluteus medius and minimus Your IT band is gonna pick up the slack. Additionally, you get tight in the hip flexors and likely your psoas. Now, some people talk about a pelvic tilt Can you get a pelvic tilt? Yes. But just because your medius and minimus are weak doesn’t mean your pelvis has to tilt So the goal: if strengthen the gluteus medius and minimus Right, you strengthen those areas and stretch, you can take some pain and strain off of the IT band The following routine that I’ve put together focuses on strengthening the lateral gluteal muscles These are comprised of the TFL, the gluteus medius and the gluteus minimus. Additionally, I’ve provided stretches. I have provided stretches that You don’t see all the time. And with those stretches at the back of each routine I give you options. So if that stretch doesn’t work for you pick another there are tons of great stretches out there And you’ll also notice that the exercises that provide There’s pretty much basic To medium to advanced and you need to pick the ones that work for you. Your body will gravitate to ones that work And you’ll start to move forward. Now, if you’re in a great deal of pain Then it’s really important that you stop running or cycling Continuing to pound the pavement or bang on the pedals can make the injury more pronounced and lengthen the duration of your rehabilitation So what are other activities that you can do? Get in the pool. Swimming is great However, when swimming be mindful of your flip turns. Don’t do really deep walls You don’t necessarily have to fire off the wall So swimming is great. If it puts strain on the legs then can you can also use a pull buoy to mitigate some of the strain. I know we’ve covered a lot of ground today, right. We’ve discussed what is IT band syndrome. What are signs of symptoms, and how do we strengthen key areas of body to combat it. Thank you very much for your time. I’ve enjoyed the discussion, and I look forward to working with you across the routine that I’ve put together

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