3 myths about the IT band

IT band syndrome, or ITBS is a very common running-related injury. We all know someone who has experienced it, likely while training for a race and ramping up their mileage. If you Google search what to do if you're experiencing symptoms you will almost certainly find stretches and foam rolling at the top of the hit list for must-do treatments. This article , based on a cadaveric study of the ITB offers some other insight into the how and why of ITBS interventions. These myths build on themselves, follow the story....
Myth #1: ITB pain in the lateral knee is caused by a bursa sac irritation
     In the study cited in the above article they demonstrate that a bursa sac could not be found beneath the site of insertion. The Gait Guys also reference a study that could not locate a bursa sac and instead attributed the purported "rubbing of the tendon" over the bursa and lateral epicondyle to have another proposed mechanism. It is anatomically probable that instead the tendon isn't rubbing at all rather we are simply feeling the loading and unloading of the anterior and posterior fibers of the ITB tendon on the epicondyle as we flex and extend the knee. What was found instead was vascularized fat at this insertion site. This fat contains many pain receptors and when under excess tension they simply send a pain message to the brain that something is not right. 

Myth #2: Foam rolling the ITB will lengthen it and decrease tension at the insertion site
  Performing stretches to try and isolate the ITB is fruitless due to the fact that the ITB is a non-contractile tissue. The term "IT Band Syndrome" a sort of misnomer. The ITB is an integral part of the fascia of the leg, not a discrete structure of its own, according to the Miller study. It's tensioning is directly and exclusively mediated by the glute max and the TFL. If the anatomical location of your pain is along some portion of the ITB we can easily surmise that the problem is not this structure that has no mind of it's own. Do not forget to examine the neuromuscular and mechanical function of the hip and pelvis. Throw "tracking problems" out of your vocabulary and figure out why the lateral stabilizers aren't doing their job. See if anything noteworthy is going on at the ankle or the foot. 


Myth #3: Foam rolling the  ITB will make the problem go away
I remember undergoing a deep tissue massage on my ITB in college in the training room. My leg was black and blue with fingerprints the next day but the pain persisted. Be specific in your rolling techniques if you're having lateral chain issues. Rolling the lateral quad, TFL and glutes makes structural sense, smashing the ITB - not so much.
   A friendly reminder to consider the anatomy when making treatment decisions. Happy running!




Sources: IT band Syndrome: An examination of the evidence behind treatment options
The Gait Guys