“The outside of my knee really starts to hurt after I run anything more than 2 miles.” This isn’t the first time you’ve said something like that. Over the years, this pain keeps popping up, and you don’t know why. Every time you get the idea that you want to try running more 5k’s, maybe even a 10k, this pain comes right back and crushes your dreams. So, what the heck is going on?
It is likely you’ve been told by some coach or healthcare professional that you are dealing with IT Band Syndrome. Maybe they even went as far to say that you need to “stretch your IT-band” (you don’t/can’t). Or maybe they just told you to “strengthen your quads” (probably not going to change anything). Well then, what is actually going on and how do you fix it?
What is IT Band Syndrome?
· Defined as pain on the lateral side of your knee that is thought to be due to irritation and friction of the IT-Band across lateral part of your thigh bone
· Often comes from friction during repeated flexion and extension movements of the knee (i.e., during running)
· The Important Players:
o Iliotibial Band – a thick band of fascia that runs down the side of your leg and connects past your knee onto your shin bone
o Tensor Fascia Latae (TFL)– a small muscle that is connected to the very top part of your IT Band at the hip
o Vastus Lateralis – the most lateral portion of your quad muscle, runs along the IT Band and actually attaches to it
The TFL and vastus lateralis are important players because your IT band itself is not what is actually tight. The IT band is such a thick and strong band of fascia, it does not tighten up or stretch like a muscle does. If anything is “tight” and needs stretching, it is your TFL and vastus lateralis muscles. So, while you may be feeling the pain around where your IT band attaches, the tension and stiffness leading to that pain is actually located in the muscles it attaches with.
Do you just stretch the muscles then? Not exactly. Stretching the muscles might feel good while you do the stretch, but that won’t address why those muscles are tight in the first place.
What Should You Do Instead?
The reason your muscles are tight, and leading to your pain, is due to the way your hip is rotating. Crazy, right? Your pain in your knee is caused by a lack of proper movement above it at the hip.
Under normal circumstances, your hip should be able to internally rotate (or rotate inwards), where your pelvis can roll over the top of your leg bone as you shift your weight over that leg. Muscles in your inner thigh, and part of your glute med, are supposed to create this motion. If you struggle creating this motion properly with those muscles, then other muscles like your TFL and vastus lateralis, will take over and try to compensate for it. This leads to overuse of those muscles, creating tension that ultimately ends up pulling on your IT band and leading to pain in your knee.
If you are going to get rid of your pain in your knee, you need to learn how to properly move at your hip.
How Do You Do That?
You need to learn how to use the proper muscles through exercise. No amount of stretching, or massage and foam rolling, will change the way your body moves.
An exercise like this one is a great place to start for learning how to get your inner thigh muscles working better:
Once you’ve mastered the basics, you can begin to progress these concepts to exercises that are more upright:
A final progression is moving on to a full split-squat type of exercise. Having your front foot elevated will help you shift into your hip and better utilize your inner thigh muscles:
It is important to note that while these limitations that can lead to IT Band Syndrome, they are not the only possible cause of knee pain. The human body is incredibly complex, and every person will present a little bit differently. An assessment by a qualified healthcare professional is necessary to determine what the cause of your knee pain is. If you are ready to finally get rid of your knee pain, then come and see us at Human Function & Performance for an assessment. You will learn exactly why your knee hurts, and we will work with you to develop a plan for getting you out of pain and back to your favorite activities. Call us today at (469) 626-7254 to set up an appointment.