Are you an athlete recently diagnosed with IT Band Syndrome? Or are you experiencing knee pain possibly related to IT Band Syndrome? Maybe you're in marathon training mode and ramping up miles according to your training schedule — and starting to feel a weird niggly knee pain that runs along the outside of your knee to your hips. Maybe you're already feeling the pain and praying it doesn't develop into anything more so you can continue with your marathon training.
If so, there are important facts about IT Band syndrome that your doctor or therapist probably didn't tell you about.
If your knee injury pain is lateral (on the outside edge of your knee for those of you who didn't go to med school), then you are likely suffering from one of the most common knee complaints – iliotibial band syndrome, or ITBS. Iliotibial band syndrome is primarily known as a running injury, but it is also responsible for about 1 in every 25 injuries in athletes engaged in other forms of vigorous training or sports that involve repeated bending of the knee.
Despite what you may already know about ITBS and IT Band pain, you may be surprised to learn that researchers have proven that the 3 most common running injuries, which include IT Band Syndrome, Patella Pain, and Stress Fractures (or shin splints in its milder form), are all caused by a common inability to maintain stability during running.
Studies show that injured runners are unable to maintain proper straight up-and-down leg alignment while running, as opposed to healthy runners who maintain this alignment in every step. This lack of alignment causes increased burden on the joint and causes injury and pain.
Traditionally, treatment of ITBS has focused on IT Band stretches and rest. Stretching and rest play somewhat of a role in treatment – don't run when you're acutely inflamed and in pain. Resting and stretching is acceptable for a short period of time – but these are NOT the solution to recovery and running pain-free. Simply stretching and resting will never be enough and, in fact, may worsen the problem by just making you weaker while you're resting and out of play.
The most effective treatment to integrate into your healing regimen is strengthening so you can achieve the alignment that's so critical to land each step properly and run pain-free. You need to strengthen so that your hips and legs are strong enough to counter the incredible force involved in each step of running. Consider that during an average one-mile run, your foot strikes the ground 1,000 times. Further, the force of impact on the foot is 3 to 4 times your weight!
It's not surprising that when you're landing during those 1,000 times, it's very difficult for your legs to land with proper alignment. With each step, you need to be strong enough to resist that force and remain aligned.
For a sound long-term recovery, you must include core strength training.
Why do runners need core strength to run?
Core muscle strength is essential to running with good form to prevent and cure IT Band Syndrome. Core muscle groups are responsible for proper joint alignment but unfortunately aren't engaged when you run. In fact, it's just the opposite: running's limited range of motion tends to weaken all the core muscles surrounding your legs and hips. Running's over-emphasis on the one dimension of back-and-forth motion repeatedly occurs with no lateral side-to-side movement, so core muscles that work to stabilize your trunk get weaker literally with each step. Compound that with the incredible force of each landing step. It's no surprise that your legs (mere limbs attached to an unstable trunk) become misaligned and start causing that IT band searing pain.
Consider this: during an average one-mile run, your foot strikes the ground 1,000 times. So if you're training for a marathon, during one "peak" training run of 20-miles, your foot strikes the ground 20,000 times. And the the force of impact on the foot is 3 to 4 times your weight! So during one peak training run, your foot is striking the ground 20,000 times with the force of 3-4 times your body weight. Your marathon training probably includes 3 of these peak 20-mile runs, so the numbers just continue to pile up. For each 'landing', your core muscles have to be strong enough to land foot on the ground in a strong, aligned way — or you're bound to feel the IT band knee pain that plagues so many of us. Or maybe for you, it's in your hips or hamstrings. Often pain in these muscles result because they're recruited to try and stabilize what your primary core muscles should be doing (and failing to do) instead.
Remember – it's actually not about leg muscle strength. Your race training more than adequately covers that. There's no doubt that you're overly repeating the front-and-back motion of running while the rest of your surrounding muscles which laterally stabilize — and are SO important to safely landing each step — continue to get weaker and atrophy. This pattern is no surprise because by definition, running is a forward-and-back motion. That's why injuries like the IT Band syndrome plague runners in a predictable way. The only way to attack and stop the pain is to strengthen the core muscles that have to get back to the job of laterally stabilizing your trunk and legs for each foot landing of your runs. It's as simple as that. The core strengthening exercises in my program are simple as that too.
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