Have you been out running or walking when the outside of your knee starts to hurt? Have you been told that you have IT band issues? The IT band is a common area for lower extremity injuries making running and long walks very difficult.

What is the IT Band? It is a tendon that runs down the entire aspect of the outer thigh, from the top of the pelvis to the shin bone. It connects the tensor fascia latae muscle (a hip flexor) and the largest glut muscle (gluteus maximus) to the outside of shin bone. The IT band’s main function is to keep our hips and knees stable. When the two muscles at the top, tensor fascia and glut maximus, contract it will create tension through the IT band, which helps to stabilize the knee-to-hip relationship.

When we see clients in the clinic who have IT band discomfort they have been stretching and foam rolling without a lot of success. They are frustrated with their lack of progress and just want to get better, but don’t know what to do. Clients are shocked and somewhat relieved when I tell them that their IT band isn’t typically the cause of their symptoms. But, my pain is right over the IT band, how can it not be the issue.

What is causing my IT band pain? At Natural Balance Therapy we are going to look at and address the entire body and the areas above and below the IT band. Here are key areas that are typically contributing to the symptoms:

1. An imbalanced pelvis. A high percentage of clients come into the clinic with a rotation in their pelvis which creates a leg length difference. The bones of the pelvis don’t move on their own and are pulled out of alignment by the fascial tension. When there is an imbalance in the pelvis it can produce a myriad of symptoms including IT band issues. The muscles in the hip, pelvis and legs are now being asked to work even harder to try and stabilize an imbalanced system. Over time the increased work in these muscles will lead to pain and discomfort.

2. Lack of stability. When our clients perform stairs, walk/run, or squat we see their thigh/knee rotating and moving inward. The muscles that prevent the knee from moving in these directions are weak and can irritate the IT band.

3. Excessive sitting. This can chronically shorten the tensor fascial latae and hip flexors while overly lengthening the glutes. Over time this can cause an imbalance in the ability for the muscles to activate, weakening our glutes and hamstrings leading to a lack of stability and tension.

So, what do we do about the pain? For starters, foam rolling isn’t the fix. For most people it is extremely painful to roll their IT bands, it provides minimal to no relief, and usually aggravates the pain. If you only foam roll and don’t address the other contributing factors you are never getting to the underlying cause of the pain.

The first thing we have to do is create balance in your pelvis by addressing the fascial restrictions that keep pulling the pelvis out of alignment. Once the pelvis is maintaining a better alignment then we can addressing the muscular imbalances. Usually this includes strengthening for the core and muscles that extend, externally rotate (rotate thigh to the outside) and abduct (move the thigh to the side) the hip. The gluteal muscles are our prime movers and will be worked to help ensure a more normal movement pattern for the hip/knee. If we don’t focus on pelvic alignment first then we will be strengthening the compensations that the body has learned which can only lead to more issues. As the pelvis starts to come back into alignment those glutes can start to fire more easily and this is the time to focus on strengthening them.

If you are struggling with IT band discomfort know there is hope, but remember we have to look elsewhere for the cause. The IT band typically is not the issue and treatment needs to be addressed in other areas. If you are out there and suffering from IT band issues, seek out help! Call today with any questions or to talk to one of our therapists.