Have you been experiencing hip pain and it’s been determined the injury is stemming from your IT band? If so, you’re not alone. IT band syndrome (Upper ITBS) is a common complaint among runners and athletes. However, there are ways to fix the issue and get back to doing what you love without constant pain. In this blog post, we’ll discuss some of the best ways to rehab Upper ITBS and get back to feeling like your old self. Keep reading for more information!
The iliotibial band is something every runner we know hates to deal with. And with good reason.
A peek inside the anatomy of the IT Band
The IT band is a very important part of the body. It helps to support the main bone in our body. Our calves and hips are built this way, as well as our forearms and shoulders. There is always a two-bone system supporting these structures. In our arms, we have two bones that allow us to rotate our hands so we can wave them. In our ankles, we have two bones: the tibia which helps support our weight, and the fibula is the second pillar. However, in our hips, we don’t have these structures.
Instead, in our hip, we’ve got one thick bone called the femur and then you’ve got the IT band and the support of it. What we have learned in dissecting IT bands on cadavers is that the anatomy books don’t reflect it properly.
There is more to IT band issues than just getting your hips stronger. Many people think that’s all you have to do, but it isn’t the whole picture. They may think: “Maybe I just need to get my hips a little bit stronger. Perhaps I need to use a foam roller and roll up and down.” This is not a bad thing at all. A lot of people have been helped with this, but that’s not everything.
Imagine the femur (the bone of the thigh or upper hind limb, articulating at the hip and the knee) encapsulated by the hip socket (acetabulum). The IT band is not just one straight line. It wraps around and connects to bone all along the shaft of the femur. Then it spreads out where it starts from the head of the femur and the acetabulum, covering the hip bone.
When it gets down to the knee, it does the same thing. It branches into the different parts of the knee, making the whole system work as one.
Foam Rolling and Lubrication
People use foam rolling (myofascial release) techniques in alleviating muscle pain and tension. They do this because as we run, we can develop small adhesions along the path of the IT band. Now, the friction taking place causes inflammation. In turn, inflammation causes our body to go into a reactive mode where it tries to thicken, fortify, and hold things down.
But as we age, we don’t have the same level of instructive cells or stem cells that have the blueprints of the body and help decide what goes where. As a result, the body is somehow going on the fly and these adhesions developed as we age.
Foam rolling can help break down some of the adhesions in the body. This helps keep things moving and flexible. But if there are adhesions that start to form and don’t break down, then things can get stuck. This makes the joints not move like they’re supposed to. Structure are lubricated and moving the way they are designed because it distributes stresses across multiple different structures within the hip.
If you have an adhesion, it means one area is not getting enough stress, while another area is getting too much stress. The areas getting too much stress break down and cause other problems. So the fact that you have IT band issues means the discomfort you’re feeling is not just in one spot. It’s also causing stresses in other parts of your body which will make the joint age faster and work less well.
The Rectus Femoris
As a runner, you’re likely familiar with the pain on the side of your thigh, from your knee to your hip. You’ve probably tried foam rolling and strengthening your glutes, but the tension keeps building up. That’s because there’s probably a little secret spot further up on your hip that’s causing everything to misbehave. What’s that little secret muscle?
The rectus femoris is a muscle in your leg. We see this all the time in people who have pain in their hip. People will visit their massage therapist, physical therapist, or chiropractor and have the tensor fasciae latae dug in with their elbows to help it out.
What it is is a part of the quadricep muscle has a little tear underneath there. Because all these structures work together, then the IT band area on top of it can start to misbehave further.
Here is the big secret. If you have IT band pain and it seems to go away but then it comes back again and again, even if you stopped running, which is sacrilegious for runners, then this muscle group might be causing the problem.
We often see people who have labral tears (an injury to the tissue that holds the ball and socket parts of the hip together) also have this same issue. For a long time, it was kind of mysterious, until we got into some cadavers, dissected them, looked at them in closer detail, and found the indirect head of the rectus femoris is attaching to the same spots where the labrum (a rim of soft tissue or fibrous cartilage that surrounds the socket of a ball and socket joint to make it more stable) sits and the joint capsule sits.
This may also mean if you start to develop tendonitis there, it’s a chicken and egg scenario. It will seem unclear if it’s happening because the labrum has torn or the labrum tore because that area was misfiring and dysfunctioning.
Keeping the IT Band Healthy
One of the first things is, to try the basics that have been proven to work. Get your glutes and hips stronger. Use foam rolling so that the soft tissue is moving well and nicely lubricated in those hyaluronic acid chains on the sides of your leg. If it seems like everything’s getting better, but the pain seems to be focused on one area, not getting better, perhaps you should put a little bit more emphasis right on the spot on the side of your hip.
Should you still have pain in the same spot, it still feels tight, everything’s achy from there and you keep on feeling like wanting to put pressure on it again, you probably have some small tear there. This is where we can come in and help.
A lot of people label it as bursitis, but almost never it is bursitis. Bursae become irritated when tendons are problematic and they’re not doing their job or not creating appropriate lubrication.
If you have been having problems with your bursa or IT band for over six months and it is not getting better, it is time to come in and see us. We can use an ultrasound machine to take a closer look at what is going on. We will be able to figure out where the tears are.
We can use exercise, prolotherapy, PRP, and many different techniques to fortify the damaged structures and get them moving the way they should. No runner should have to stop running because they continue to hurt.
Upper IT band syndrome is a common injury for runners, but it doesn’t have to derail your training. In this post, we outlined some ways you can do to help keep the IT Band healthy and functioning properly. We also took a look at the anatomy of the IT Band and discussed how to strengthen the muscles that attach to it. If you’re suffering from upper ITBS, be sure to try these methods and see if they provide relief. And if you still need some help, don’t hesitate to schedule a discovery call with our team! We would be more than happy to discuss your specific situation and create a plan tailored just for you.
If you’re experiencing hip pain and more stemming from an injured IT Band and would like help getting to the bottom of it, we’d be happy to schedule a discovery call with you. During this call, we can discuss your symptoms in more detail and come up with a plan tailored specifically for you.
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DISCLAIMER: The information in this email is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. All content is for general informational purposes only and does not replace a consultation with your own doctor/health professional