Many a runner has been sidelined by knee pain caused by the iliotibial band (aka the ITB). But knowing how to deal with this long band of fascia, which runs down the outside of the thigh from the pelvis to just below the shin, can help keep an injury at bay. Knowledge is power, and we want to help keep you on the road.
First off, fascia is a stiff connective tissue (like tendons and ligaments) that surrounds muscles, bones, and joints, providing both support and protection. It's like shrink-wrap; once fascia becomes tight it tends to stay tight, causing pain and injuries. When the ITB shortens, usually due to poor biomechanics (like losing your running technique when tired), it can pull the kneecap out of alignment. The faulty alignment creates inflammation in the joint and pain when bending the knee. This injury, known as iliotibial band syndrome, occurs more in women than men, most likely due to the wider female pelvis.
To avoid overuse injuries, it's important to keep this thick band of fascia flexible, especially if you're training for a race and upping your weekly mileage. Keep reading to learn how.
We recommend a combination of foam rolling and stretching when the body is warm from exercise. Try this sequence after your next run or workout.
Using a foam roller, massage the ITB by rolling up and down the outside of the thigh. Watch this video to learn how to roll out the thigh. Chances are high that rolling out your ITB will be painful, but the slower you go the more effective the massage. When you find an especially sore and tight spot, rock slowly back and forth massaging the area from side to side.
After massaging the outside of the leg, you need to stretch the area. Here are two stretches; try them both and see which one feels most effective.
- Standing: Bend in half at the waist and hang over, and cross your right foot behind your left, pressing your right big toe down into the floor. Twist your upper body to the left and hold onto your right leg. You should feel a gentle pull on the outside of your right leg. Hold the stretch for a minute. Uncross your legs and switch legs to stretch the other side.
- On the ground: Lie on your back, with knees bent and feet flat on the floor. Place a strap (a belt from a robe works in a pinch) on the sole of your right foot, and holding the ends of the strap, reach the right foot toward the ceiling; this is a basic hamstring stretch. Keeping both sides of the pelvis flat, cross the right leg over your body to the left. Hold for 60 seconds. You should feel a stretch on the outside of your right leg.
The iliotibial band and the glute max, the biggest of the booty muscles, are connected. Keeping your glutes flexible will help keep the ITB from becoming excessively taut. Try the popular yoga hip opener Pigeon to stretch your posterior or one of these three glute stretches.
If you're feeling some tenderness in your knees when you go down steps or walk downhill, start following this sequence and see if it helps. Keep on running!