Iliotibial Band Syndrome and the Role of Massage In Healing It

Iliotibial band syndrome is the name given to an injury that causes pain and tenderness along the outside of the thigh and knee or just above the knee joint. If you engage in activities such as running, cycling, hiking or long distance walking that involve repeated flexion and extension of the knee, you could be at risk.

What exactly is the Iliotibial (IT) Band?

Your IT band is a thick band of connective tissues that sources from the fascia in the gluteal muscles, runs from the iliac crest in the pelvis, across both hips, over the thigh and past the outer knee. It attaches to the top of the shinbone.

This band of fascia is responsible for maintaining stability on the outside part of the knee.  It is supported in this function as it moves over the bony extension at the top of the knee by the bursa, a fluid filled sac, which is located at the top of the knee. The bursa assists in the smooth movement of the IT band over that area during flexion or extension of the knee.

This IT band is also part of the hip abductor muscular structure that assists in moving the hip outward during movement such as walking or running.

How the IT band sustains injury…

The repetitive motion of running, cycling or walking long distances can result in irritation and inflammation of the bursa. This causes increased friction between it and the fascial tissue of the IT band as it passes over the bony area above the knee.

The more this occurs (with prolonged motion), the more the band tends to tighten from the repeated rubbing which causes pain along the outside of the knee joint.

If the symptoms are not treated, the knee can become swollen and more painful. In the extreme, scarring of the bursa can occur which increases the pain and restricts range of motion in the knee.

Causes of IT band syndrome:

• Improper training techniques –including
  • over-training,
  • not enough warm up or cool down and
  • poor footwear
• moving across uneven or slanted surfaces such as hills, banked pavement that throws the body’s movement off balance.
• If you have any physical restrictions such as:
  • weak core muscles
  • arthritis in the knees
  • structural disfiguration in your legs (bowed legs)
  • you tend to rotate your gait inward (take a look at the wear pattern of your shoes to determine this)

What Are the Symptoms?

The most identifiable symptom of IT band syndrome is having pain on the outside of the knee. It may go away after warming up but eventually worsens with exercise.

Other symptoms include:

• discomfort throughout your whole leg
• visual redness and heat at the side of your knee
• sensations of popping on the outside of the knee when moving
• tenderness to the touch on the outside of the knee

Treatment of IT Band Syndrome

As usual in cases of inflammatory issues, (RICE) – rest, ice, compression and elevation are the first approach. The condition does heal over time.

How Massage can help: 

Traditionally, the approach has been to use intense massage strokes and rollers at the site of the pain. However, the focus that is most effective is to target the muscles that will release the tension at the source – at the glutes and with the fascia bands themselves with the use of such techniques as trigger point therapy.

Prevention is Possible

IT band syndrome is highly preventable with a few steps in your exercise regimen:

• Include stretching and strengthening exercises for your glutes, lower back and leg muscles
• Always warm up and cool down as part of your workout
• Make sure your shoes are in good repair and not worn down

Consider saving yourself pain and discomfort by putting these simple techniques to work in your routine.