The Care and Feeding of your IT Bands

Ok, alright. I know they aren’t pets. But issues with an IT band can be a huge pain in the knee. And pain here can really squelch a training program. As fall marathon training season ramps up in mileage, it’s not uncommon to hear from this anatomical structure about now. So let’s learn a little about how to take care of it!

First, I’ll give you a bit of an anatomy lesson. Your IT, or iliotibial band, is a multi-layer bundle of connective tissue that originates from your hip, incorporating fibers which begin mainly from the tensor fascia lata muscle, but your glutes contribute as well. It also is fused to bone in certain points, so describing its function is as complex as its multiple connections. It inserts on the lateral side of your knee. It is thought to act like a spring when running, building up and releasing tension to help propel us more efficiently. When this fibrous structure is inflamed, it lets you know with pain at the insertion point.

What causes IT band syndrome, you ask? Well, those new to distance running may increase the length of their runs too quickly. Runners may have muscle imbalances and decreased flexibility in addition to relative over training, including weight lifting.

As runners, we tend to brush off minor pain, convincing ourselves that it will simply go away. However, pain at a specific place is your body’s way of warning you that something is off, so it’s important to listen to these signs.

When I had issues with this myself, I was marathon training in addition to regular and intense cross fit training. The pain began as an intermittent niggle that would start a few miles into a run, feeling like a tightening pain on the outside of my knee, worsening every time I stopped running. It would loosen up again once I started running, and that cycle would continue until the end of my run. It was also tender to the touch on the outside of my knee. The pain eventually reached a point that it was difficult to navigate down stairs, and at times, it felt like my knee would buckle. The only cure at this point was to not run. Folks, you do not want to ignore the pain and let it get this bad!

So what do we do if we have IT band pain? The same things you should be doing on a routine basis to prevent problems!

• First course of action if you are experiencing pain is to rest at the first signs of issues. Take a few days off from running. It won’t kill you, I promise. Give your body a chance to deal with the inflammation and simmer down.
• Gentle foam rolling.
  • Avoid long sessions over the IT band itself. Instead, focus on the TFL at the top of the band, quads on the front of your thighs, and the glutes and hamstrings on the back. Don’t go crazy. Just a few minutes a day should help release any tight muscle fibers creating imbalances.
  • Alternatively, you can use a stick style roller or a massage gun, but foam rolling is still a favorite for me.
• Stretch. Do this after your foam rolling. I have a few favorites which target the muscles that contribute to the IT band, but you also want to incorporate stretches for quads and hamstrings in your routine.  I’ve listed the 3 that I do frequently, but I’m also linking this great article about a variety of stretches that help the IT band!
  • Standing IT band stretch (also great to do mid-run if you feel discomfort)
  • Tailor sit stretch. This one is easy to do while you are sitting at work!
  • Cow Face pose (leg portion only)(don’t forget to switch sides!)
• Incorporate strength training. If you work on strengthening your hip abductors, extensors, and rotators, you can take some stress off of this structure.
  • Clamshells
  • Bridges/single leg bridges
  • Sidestepping with resistance band
  • Squats
• If your pain does not settle down with a few days of rest, stretching, and gentle foam rolling, see a sports medicine doctor. In my experience, you will be happier if you see one who is also a runner. They may recommend physical therapy. If you are a Sports Backers MTT participant, you have fast track appointments with VCU Health, just another benefit of the program. Reach out to your coaches if you need this!
• Keep incorporating the above foam rolling, stretching, and strength training into your cross training and recovery routines for prevention.
• Avoid running on the slant of the road. Especially in older neighborhoods like we find in Richmond, some roads tend to be significantly cambered. So when your coaches tell you to try to run toward the crown of the road, listen! Running on the camber is essentially creating a functional leg length discrepancy. This can create all kinds of imbalances.
• Make sure you are in the right shoes for your running gait. Your local running store is your best bet for getting fitted for the right shoes. It’s really important that they do a running gait analysis, because your walking gait is not the same. 
• If you are close to race day and the pain is tolerable, you can consider KT taping, but this should not be your first course of action, nor is it ideally something to try for the first time on race day.

Bottom line is that if you want to be able to run consistently over multiple training seasons, you must put in some work to take care of your body. The above strategies will not only help keep your IT bands happy, they will also help prevent other overuse injuries. It all works together.

Stay tuned for more cross training tips as our MTT season progresses! While our racing season for 2020 may very well be virtual, the training is still real, which means the risk for injury is as well. It’s far easier to prevent injury than it is to recover from it. I give you this information as a courtesy and assume no risk for injury sustained by taking my advice. It is important to see your doctor if injured.  As always, I hope you all are safe and healthy.