If you’ve had Iliotibial band (ITB) Frictional syndrome, then you know how much it hurts, and how it feels like it’s never going to go away. I’ve had it more than once many, many years ago before I knew how to train and eat properly. It’s one of those pains in your knee or the outside of your leg where you go out for a run, and have to limp home. I was miserable – and taking high doses of NSAIDs didn’t help and rubbing DMSO only made me stink! (Runners out there know the DMSO smell.) Many suffer with this injury for months. It’s like a knife digging into the side of your leg or knee. The ITB is an extension of a short muscle on the side of your hip called the tensor fascia lata (TFL) as well as your gluteus maximus muscle, (that’s your behind). The ITB extends from the TFL and glut max down to the outside of your knee.
Pain occurs anywhere along the ITB, usually at the insertion (by the knee) or somewhere in the middle. You’ll have pain running, walking [usually down] stairs, and anytime you try to bend your leg, especially after keeping it straight for a while. Waking up in the morning will be like an ice-pick in your leg. If you’ve ever had ITB(F) syndrome, you probably went through a whole slew of treatments and still had it for 3-6 months; that is very common and no fun. Medical treatment is cortisone shots and NSAIDs for inflammation and if that doesn’t help, then surgery is recommended to cut and release the band. > That sounds like fishing, but much more miserable because someone would actually be cutting into a thick sheath of tendon, leaving the leg much less stable than what it was before going under the knife. ITB syndrome occurs typically from the following reasons.
Often there is an actual weakness of the TFL or glut max itself. 75% of the ITB is made up of the glut max – the major leg extensor powerhouse muscle you use to jump, climb, squat, run, ride your bike, and even just to get out of a chair. This weakness could be from a structural imbalance, an injury somewhere (anywhere in the body), an insulin issue from eating too many carbohydrates creating a gait disturbance, or even from a digestive problem, (gut inflammation can inflame the ITB). One or both of those muscles could have fatigued from wearing the wrong type of shoes or orthotics, or even from an old injury that is still haunting you, but you don’t know it because the pain is gone, but your body has compensated.
Second, ITB Syndrome can also occur from an imbalance between the inside and the outside of the leg. The muscles that support the inside of the knee are related to the adrenal glands. These are the sartorius, gracilis, as well as one of your hamstring muscles on the inside of the back of the leg that wraps around to the inner lower knee. If there is an adrenal involvement from overtraining and/or too much life stress, these muscles will weaken, causing an over-firing of the muscles on the outside of the leg/knee, which as you now know, is the ITB and TFL. Or the muscles on the inside of the leg could be working too hard so the outer leg muscles – the TFL and gluteus medius and minimus – are pulled inward, essentially torquing the leg. Treating the injury with this understanding usually corrects it very quickly, often within a couple weeks, if not sooner.
Check out the Sock Doc ITB video here!
Also read how Sock Doc treated a local East Coast runner successfully who had ITBS for months here.
This is precisely what happened to me —over-training, running hills, and increasing my distance too quickly, I suspect. Everything you mention is applicable to my case —sharp pain, especially walking down the stairs, trying to bend the knee (like a broken hinge), etc, etc.
You assert that we shouldn’t ice it or stretch it, which makes perfect sense; but this also begs the question —just what do we do?
Perhaps I would be well-served wrapping it up, getting a brace, and just taking time off until it mends itself?
I went from zero running in 15 years to running 2.5 miles my first time out three weeks ago to running 11+ and ‘running through the knee pain.’ Lessons learned the hard way.
“What do we do”? – Start by what I discuss in the post and video!