The iliotibial band (ITB) is a long tissue made of fascia, that runs along our lateral thigh. It is formed by two muscles: tensor fascia late, and gluteus maximum, both combining in the upper lateral thigh, and the ITB then attaches to Gerdy’s tubercle, which is on the lateral side of the tibia (our knee joint). The ITB is commonly injured in those that run either as their activity, or as part of their sport. It can also be present in people who do lots of jumping such as seen in HIIT classes, or F45/CrossFit-type classes.

What is the ITB?

The ITB attaches at multiple points of the hip and knee, and acts as a spring on the side of our thigh to absorb and produce energy during running and other sporting activities. This tissue provides stability to our hip and knee when only one leg is in contact with the ground. It is thought that ITB pain is usually as a result of a large spike in loading of the ITB, beyond what it can handle. In this case, the distal end of the ITB can get irritated, causing pain on the outside of our knee, especially while:

• Walking

• Going downstairs

• Running

• Jumping

• Changing direction on the field or court

‘’I should stretch the ITB right?’’

Over the years, stretching and foam rolling the ITB has been used in gyms and living rooms worldwide to ‘release’ or stretch the ITB. This tissue is in fact extremely robust, and studies have shown that it can require 600kg of force to stretch the fascia, which means that your foam roller is having no stretch effect. Although some people get relief from ‘stretching’ or foam rolling the area, this is a very temporary change in discomfort, and the root cause is not being addressed. 

Rehab Options 

If you’re suffering from ITB, there’s a few things that you can start doing immediately to try and manage your symptoms.

Strengthening:

It’s a rather general term to ‘strengthen’ your legs, but a focus point to begin with is to increase your hip abduction strength. This involves loading your glutei medius and other hip abductor and begin to feel that ‘burn’ on the outside of your bum in the gym. Exercises include sidelying leg raises, fire hydrants, or box step ups.

Running Technique Modification:

There is some evidence that increased hip adduction (leg coming across your body) can be a factor in ITB pain. A training change you can implement is to increase stride width. Imagine that there’s a train track 15cm apart in front of you and have each foot land on track which ‘widens’ your stride width.

Reducing mileage:

An immediate change that will be beneficial would be to reduce your weekly mileage, reduce speeds, and avoid downhill running for a few weeks while you begin your rehab.

 If you have any questions on whether physio is the best option for you, or you have any questions about MVMNT in general, feel free to contact via email.

- Jay Towolawi, Specialist Sports Physiotherapist and MVMNT Founder.