Wednesday, August 15, 2012

IT Band Knee Pain (Foam Rolling, Stretching, and Strengthening)

Life Rule: If something hurts, you should probably just foam roll it.

Foam rolling addresses muscle tightness/knots/scar tissue by literally rolling them out (I’m not saying it’s fun, but it is effective). And that fabulous foam roll is especially effective for Ilotibial Band (IT band) problems, which in my experience account for about 90% of running problems.

So the dreaded runner’s knee? Nope not a thing. Your IT band is tight. Hips hurt? Again, probs your IT band.

I’m blogging about this now because, well, my knee hurts a bit. But don’t worry, this is a constructive post, not a whiny one! Basically, I’ll do the Googling so you don’t have to.  (So says the girl immobilized by the ice pack tied with a scarf to the side of her knee.)

What is an IT band?

The Iliotibial band is a layer of connective tissue that goes from the lateral hip and attaches down below the outside of the knee. Runners usually feel IT band pain in the side of the knee, but it can also hurt up in your hip where the IT band connects.

What causes it to hurt? 

  • Muscle imbalances (Quadricep muscles that are too strong in relation to the Gluteus Medius and Minimus);
  • Running downhill fast;
  • Running on flat even surfaces (i.e. pavement) while heel-striking/over-striding.

How do I treat this problem?

1. Rest. A couple days off to let the area calm down should do it. But time off without any foam rolling or stretching probably won't do anything.

2. Foam roll. Aah the aforementioned foam roll. There could be a knot at anywhere between your hip and your knee, so just use the foam roller to find it, then roll over that place repeatedly until you want to cry/scream/have to stop (I told you it’s not fun).
  • Sidenote: I had an injury in college that was originally diagnosed as a knee problem. So I did the prescribed stabilizing and strengthening exercises for a couple weeks, but it did not get any better. Then long-suffering ever-patient cross country athletic trainer (God bless Brian for not murdering all of us) decided to start back from square one and re-evaluated me. He was testing the muscles in my leg when he came across a giant knot – Mollie, what is this????? Ummmmmm? My leg is just like that? No. And then we progressed to an extremely bruising series of Active Release massages and a lot of “foam rolling” on a PVC pipe. Painful, but it worked!
3. Stretching (source)
  • Stretch #1: Pull foot up toward your butt. Cross your uninjured leg over the injured leg and push down, hold for 30 seconds.

  • Stretch #2: Cross injured leg behind and lean towards the uninjured side. This stretch is best performed with arms over the head, creating a "bow" from ankle to hand on the injured side (unlike how it is depicted).
  • Stretch # 3: Cross injured leg over the uninjured side and pull the leg as close to your chest as possible.

4. Strengthening
  • Side leg lifts: Lie on the ground on one side with legs straightly aligned. Contract your hip muscles to open your hips and raise your top leg. Keep leg straight and lift to a 45-degree angle from the ground. Pause for one second, then slowly return your leg to the starting position.

  • Standing side leg lifts: Stand with both feet together. Lift one leg out to the side while keeping your body upright (don’t lean!) It is more important to maintain good form than to lift your leg high. Slowly lower and repeat on the other side.

  • Single Leg Step Up

Also read my post: “Hip Flexor and Piriformis Stretching and Strengthening.”

How do I prevent this from happening (again)?

  • Get off the road or treatmill and run on uneven surfaces (grass! trails!) to strengthen your balancing muscles.
  • Avoid over-striding and heel-striking.
  • How old are your shoes? How many miles are on them? Could it be time for a new pair?
  • More info from the Runner's Corner.
Hope this is useful!