- Shay Johnson PT, DPT
How well do you actually know your IT Band?
IT Band Syndrome (ITBS) is a common overuse injury for the endurance athlete population, but everyone is susceptible to this condition. The IT Band, or iliotibial band, is a long flat non-elastic connective tissue that originates at the top of the hip and inserts just below your knee joint on the tibia. It is “tensed” by 3 muscles-- Tensor fascia latta, Gluteus medius, and Gluteus maximus.
IT Band injury is caused by both repetition and poor hip biomechanics. As your knee flexes and extends with running or pedaling a bike, the distal part of the IT Band has to slide back and forth over the the widest part of the femur bone just above the knee joint. This rubbing is exacerbated by weakness in the hips allowing "hip wobble" or the hips falling into adduction/internal rotation. "Hip wobble" is when the hip drops in a single leg stance due to weakness of the opposite weight bearing hip. This places the 3 muscles listed above on stretch, which adds more tension to the IT Band. When the hip falls into adduction and internal rotation, the IT Band is subject to increased tension just as it is with hip wobble. The increased tension on the IT Band will then endure increased friction as it slides over the femoral condyle repeatedly.
If you're experiencing ITBS, reducing your activity will play a pivotal roll in your rehab. ITBS is an injury and requires time to heal. In addition to activity modification, physical therapy is a great place to start rehab for ITBS. Your physical therapist will focus on reducing the tightness and hypertonicity in the muscles that put tension on the IT Band and try to improve the relative motion of the IT Band with the adjacent structures. Then, working on both hip strength and mechanics will be the most important part of the rehab process because this will help prevent further bouts of this condition.