There are many articles dealing with the complexity of this anatomical structure and it is blamed for all sorts of problems. Firstly I wanted to say a few things about it.
It is a long and broad anatomical structure from the pelvic bone (known as the ilium) and it travels widely down the leg to attach to Gerdy's tubercle (Pierre Gerdy, a French anatomist who gave his name to the bony prominence where it is attached). It is a structure which you cannot stretch! It is a tough fibrous tissue that helps with stability, so why stretch something that is there for stability? You can't do it and you don't want to as it is fruitless. Structures that surround it and are attached to it are often restricted and so targeting them may be more beneficial. So why does it become painful?I think the science has reached a stage whereby we accept that inflammation is unlikely; there is no bursa (fluid filled anti-friction structure) so swollen bursa's are not the problem; but it may be painful because there is too much load going through it. Loading pain. Adjusting the load down through the leg and the problem will disappear, sometimes very dramatically within a few sessions of treatment.Assessment usually finds that some of the muscle groups around the hip become shortened over time and some muscle groups don't engage in a way to transfer this load better down the leg.
Top tips for ITB syndrome:
Running Bug Tip: Try these Foam Roller Techniques.
Notice I didn't say massage...there are a lot of massage techniques which boil down to altering the stiffness of the tissues you are working on. The science supports that. Yes, massage helps healing, blood flow, recovery etc but the type of soft tissue work in this case is about altering stiffness through a structure and helping the body to find its natural running pattern again.I have not found orthotics helpful in these cases. I have never found a runner with ideal biomechanics and so where do you start....Anyway this is my experience of the condition and the tips that people have fed back to me on what has worked for them... If you are suffering, try a few of them...Now today...I am off for a VO2 test...I'll keep you updated.
That was very interesting. I have looked into the release thing, but the nearest practitioner is 50 miles away. Is there a self release technique you could suggest?
SO what treatment IF ANY would you recommend ?
Although I personally agree that the ITB can't be 'stretched', it should be noted that not all doctors or physios agree with this position. The top tips here seem spot on. As far as treatment goes, self-myofascial release - or SMR - seems to get good results and can be done on your own with a foam roller. Lie the outside of your leg on it at 90 degrees to the roller, and roll on the meat of the thigh, not as low as the knee joint or as high as the hip. It can be quite painful. Actually, very painful. Then, by way of stretching and strengthening hip structure and glutes - and also as a way of treating bad posture, always the prime cause of most running injuries in my experience - I would recommend pilates.
Hi guys,
Please bear in mind that this is my opinion but it is reasonable informed from the evidence. I agree with RobbE
Most 'therapists' will be familiar with the technique but try not to get overly hung up on it, essentially this is where the science is lacking. The application of firm pressure via the foam roller is a fabulous self treatment but don't just target the ITB, do the Tensor facia lata the soft fleshy muscle you can see when you flex your hip on the outside of the upper thigh.
The pain thing is also up for debate. Yes it will be painful but it's often described as a good pain which is very subjective. My theory is that it should be a pain that eases off in about 20 secs of direct pressure not too dissimilar to a trigger point effect. Bottom line it' alters pain and stiffness. Check out the many YouTube clips on this one but do the leg training to keep your running form and get back running as soon as your leg allows it.
My view on Pilates is that the traditional floor work done in class scenarios won't offer any differential on traditional strengthening. Pilates is great but you may need an instructor to identify key Pilates manoeuvres that compliment running. My views on Pilates will emerge in time...
Thanks for your contributions.
Matt
Thanks guys, you've covered it brilliantly. I do use foam roller and its a love/hate relationship...but can see the benefits. Ive never done it with the leg bent so with definately give that a go. Pilates left me cold 'literally' but I do 'do' yoga with an instructor
In my opinion, I think that the foam rollers are excellent for maintenance , but, it is very hard to in flicked pain on yourself, its good now and then to let the therapist do it as they know (or should) exactly how much pain you can take. there is know substitute for hands on treatment if its done correctly
Derek
Absolutely Derek or I would be out of a job!! I will you posted on any new developments I come across either from patients or the literature. Thanks yor your contributions.