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IT Band Friction Syndrome – When Knee Pain Comes From the Hip


 

What is the IT Band?

The iliotibial band (IT band) is a very thick, fibrous band of tissue that runs from the outside of your hip down the outside of your leg and connects on the outside of your knee.  Your glutes, hip abductor and tensor fasciae latae (TFL) muscles all connect into this band.

 

leg image

What is IT Band Friction Syndrome (ITBFS)?

A sudden increase in mileage (over a 5% increase in one week) or excessive downhill running can cause the IT band to rub and create friction on the outside of the knee creating pain.  Since the IT band has fibers that also connects into the outside portion of the kneecap this can also be a source of pain at the front of the knee.

What Causes ITBFS?

Remember Newton’s 3rd Law of motion that “every action has an equal & opposite reaction?”  During running, every time our foot hits the ground with a certain amount of force the same amount of force is also exerted from the ground back up through our foot and into our leg.  If the musculature involved (usually the muscles on the outside of the hip) cannot contend with these increased impact and force requirements, then the body can start to break down and often times this occurs at the knee.  A rapid increase in running distance, downhill running, or running on slanted or graded surfaces (the same side of the road every run) forces the legs to undergo a significant increase in impact and force.

How Do I Fix It?

Decreasing your mileage temporarily until your symptoms subside then increasing more gradually sometimes can help initially.  Increasing your cadence (steps per minute) can help because it decreases the time your foot is on the ground, limiting the returning force the ground can exert back.  There is research data to indicate runners with ITBFS may have weaker hip muscle strength on the affected side.  So strengthening those muscles on the outside of your hip is KEY and is very simple with performing either, or both of the following exercises (to be performed every other day at 3 sets of 10 or 15 reps):

exercises

The following stretches after your run will also be helpful to loosen those tissues & muscles on the outside of your hip holding each stretch for 30-45 seconds, 3 times daily:

stretches

HAPPY RUNNING!

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BRET MAIERS, PT, DPT, OCS

Bret Maiers received his Doctorate degree in physical therapy from Eastern Washington University in 2010.  He is a board certified orthopaedic clinical specialist through the American Physical Therapy Association and is currently the clinic director for Mountain Land Physical Therapy at their Stansbury Park location. In his spare time Bret enjoys running and both watching and playing sports.

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This entry was posted on Thursday, April 3rd, 2014 at 8:53 am and is filed under Common Running Injuries, Exercise Physiology, Expert Answers, Injuries and Pain, Injury Prevention, Sports Medicine. You can follow any responses to this entry through the RSS 2.0 feed.

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