13 Jul 5 Reasons Why Your Iliotibial Band Syndrome Is Not Improving
Why is it that your Iliotibial Band Syndrome is not improving..? (and you keep trying)..
As explained in our previous post ITBS Causes and Treatments, Iliotibial band syndrome is a very common causes for knee pain among runners. It accounts approximately for up to 12% of running injuries and up to 24% of cycling injuries (this condition is often mistaken for a knee injury).
The iliotibial band is a type of soft tissue that runs along the side of the thigh from the pelvis to the knee, and ITBS occurs when excessive irritation causes pain at the outside (or lateral) part of the knee.
This irritation and inflammation arise from friction between the ITB and underlying structures when someone moves through repetitive straightening (extension) and bending (flexion) of the knee. Typically, ITBS pain occurs with overuse during activities such as running and cycling.
Many athletes will suffer ITBS where in many occasions they will see their recovery period being longer than expected, and in some instances, many runners will also experience a re-incidence in the condition.
In average ITBS can take between two to six weeks to heal, depending on the severity of the issue and how effective the recovery can be.
If the condition not only takes longer than expected to heal, but we seem to be getting in the same hole over and over…what is it that we are doing wrong in the process?
Some factors can contribute in ways that ITBS will not improve:
1 – Weak Hip Muscles – Excessive Dynamic Valgus
We are not paying attention to our Hip muscles. Weak muscles in the hip tend to cause your running form to break down, which puts a lot of stress on the tissues in the knee
Weakness in Gluteal Muscles is always found to be a leading factor for ITBS, where these muscles are unable to control the dynamic valgus alignment of the lower extremity causing excessive use of the Iliotibial Band for maintaining the running form
What you can do
Hip dominant exercises to increase strength of Hip extensor and Hip External rotators muscles
Isometric Hip Abduction
2 – Not Fixing Your Running Form
Running Form is one of the most common causes of ITBS:
- Over striding (taking too long of steps), and
- Strides that cross over the midline of the body
These are fairly easy to notice, and a running coach can help in identifying and re-adjusting running your form. Sometimes, however, poor form can be subtler and might require something like a video gait analysis.
What you can do
Work on Running Mechanics and get your running technique analyzed by a professional. Start by understanding your stride and how impactful it is in your running mechanic. Once analyzed you can readjust running mechanics for better efficiency.
3 – Shoe or Foot Issues
Over worn shoes can cause your foot to land at awkward angles, which transfers a lot of stress up to the knee and hip, so keeping your shoes within their recommended mileage is critical.
Foot deviations and arch support anomalies will also contribute to ITBS.
What you can do
Replace old running shows that are worn out and use additional cushion if possible.
Additional cushioning (insoles) can be of great value to smooth possible foot deviations.
The Powerstep Insoles offer great support and superior cushioning.
4 – You are putting too much too fast
Think about building friction over time. If you are coming back after injury, you need to avoid:
- Additional sudden training (rapid increase in mileage)
- Additional sudden intensity of the training (hill workouts, repetitive jumps)
- More frequent races
- Too much Load, applied too fast…
If pain re-appears look for recent alterations in your sporting activities. Any changes in the frequency, duration and intensity of training should be investigated in detail.
The training program should also be appraised for errors, including increasing the exercise intensity too rapidly, inadequate recovery time and extreme hill workouts.
Educate yourself in the importance of progressive loads. For example, return to run in small amounts and with proper rest time in between practice runs. Increase load very slowly and paying a lot of attention to the pain during training and afterwards to decide when to increase load again.
5 – Lack of Flexibility
Finally let’s talk about flexibility. The ITB is a very thick tissue with almost no ability to stretch, so this is where you need to intervene.
What you can do
Foam Rolling: it will help in terms of modulating the pain but make sure your roll it on the side of the thigh from the middle up, Do not foam roll the painful area by the knee, this will only increase the irritation on the band.