IT (iliotibial) Band Syndrome is one of the most dreaded phrases that can be uttered to an endurance athlete. Caused by repetitive strain, highly repetitive movement, weak glute medius (Hip abductor) muscles, tight IT Band fascia, fallen arches, weak VMO (vastus medialis oblique), dysfunctional sacroiliac joints, weak core/abdominal muscles…. The list seems to be endless with areas in the body that can be attributed to causing or being involved in IT Band Syndrome.
A syndrome is defined as a group of signs of symptoms that occur together and characterize a particular abnormality or condition. So in the case of IT Band Syndrome it is most epitomized as lateral knee pain that occurs during a repetitive activity like cycling or running. On top of this you can take the above characteristics and apply one or all of them to it, and get your syndrome of IT Band “Syndrome”.
Every practitioner or specialist will have their own take, or preferred focus on this injury and likely will get the athlete better through some degree of rest, conservative care, and rehab. The care of this injury is not to be my focus in writing this blog, but the prevention and consistent care is. This syndrome does not occur overnight and can in fact be quite preventable. The basis for this prevention is routed in consistent work done by the person wishing to prevent the injury.
There is no one-best rehab exercise. The best exercise is the one that you are going to do consistently day in and day out. Consistency makes predictable improvements in the human body.
The human body improves via adaptation. You can only improve if you put stress on the body. The human form like all biological organisms is the best example of antifragile behaviour. If you put stress on the system it will improve. If there is no stress but on the system, or a specific muscle, tendon..etc, there will be no improvement, and in fact there will be a weakening.
Prevention of IT Band Syndrome should be focused on two areas. The hip abductors (Glute Medius being the most prominent), and loosening up the fascia that makes up the IT Band on the side of the leg. You can do this in two quick and easy steps. Use a foam roller on the IT Band for a minimum of 2min per day, no matter if you are sore on the lateral leg or not. The second is doing a strengthening exercise that works the hip abductors in a wide range of movements. The best exercise for this that I have found is called 7-way hips. Its a series of seven movements that take the hip through a wide range of movements utilized in day to day life, and specifically more ranges than the movement that typically causes IT Band injuries which are uniplanar in nature (running and cycling).
There are many more exercises that can be used to help prevent IT Band Syndrome, and I use these two just an example. The key behind them is that they must be done “Consistently”. Consistency in anything will lead to a predictable result. So if you don’t follow the above advice and don’t do anything preventative you will have consistently tight IT Band and weak hip abductors. Now in a lot of cases people won’t develop IT Band Syndrome, and may never suffer from it. In this case you are playing a game of odds and banking on the fact that you won’t be “that person” that gets IT Band Syndrome. Instead you can start integrating in preventative work now, and on top of not getting injured, you will likely have performance gains from doing the extra accessory work.
The net of the story with IT Band Syndrome and really any overuse injury, is that an ounce of prevention is worth a pound of cure. Because who wants to have to take 2 weeks off with an injury when they could continue to do the sport they love.
Dr. Adam Wade
Dr. Adam Wade 