IT Band and How to Treat IT

If you ever hang out around runners, you probably heard about the infamous IT band and its tendency to get tight. Runners routinely stretch it, roll it, and swear at it.

IT Band, or Ilio-Tibial band, is a long wide tendon of a muscle called Tensor Fascia Lata, or TFL. 

By itself, IT band does not get tight. It's not even very elastic (doesn't stretch). It becomes a problem when the TFL is overused or mistreated.

Therefore, to fix IT band t(issues), one needs to release the TFL. (see the image)

The TFL is a smallish hip flexor. Usually, it gets overused when another major hip flexor and hip joint stabilizer gets weak and tired - Gluteus Medius.

When Glute Medius stops working properly, TFL 'takes over' - very inefficiently. It's not designed to stabilize the hip and the knee. 

After a few miles, or workouts, the TFL fibers give out and tighten up chronically (i.e. stay tight even after the exercise is over). 

When the TFL fibers get chronically tight and contracted, they pull on their long tendon, the IT band... and you feel pain.

Usually the pain is at the knee because that's the attachment of the tendon. But as we know the problem is at the hip - in the TFL. So that is where it has to be treated. 

How to Treat IT

1. Stop running, biking, squatting, and any activity that flexes the hip and the knee at the same time. 

2. Start strengthening the Glute Medius and Glute Maximus. Ask your personal trainer, or google some Glute Medius strengthening exercises. 

Strength and stability in hip stabilizers will prevent further injuries and speed up your recovery.

3. Get a massage with a neuro-muscular therapist, or another experienced soft tissue therapist.

During the massage, your therapist must examine all the TFL fibers, one by one, to isolate those few chronically contracted fibers, and then be able to find and release trigger points in those fibers.

In addition, your therapist should be able to separate the IT band tissues from the under-lying Vastus Lateralis muscle. These two structures (IT and Vastus L.) have a tendency to get glued to each other which does not help with painful IT band. But massage therapy will be extremely helpful and will significantly speed up recovery.

4. Roll the TFL and the Glute Medius, as well as the Vastus Lateralis, with a foam roller, or a tennis/golf ball.

You really don't need to roll the IT band itself. If you like to torture yourself, go ahead, but it's unlikely to make a difference. As mentioned, IT band is an inelastic tendon and rolling it makes little impact on its flexibility.

However, rolling the TFL, Glute Medius, and the Quads, Vastus Lateralis in particular, is going to be helpful.

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