Iliotibial Band Syndrome – Running and Cycling

There are many knee pains and injuries that can be very painful. One of these is called Iliotibial Band Syndrome (or IT Band Syndrome). It can be a frustrating and debilitating injury that effects the knee and hip.

IT Band Syndrome is an example of an injury that generally occurs over time, not like an acute back spasm or ankle sprain. It usually starts as a nagging injury, or nuisance feeling and quickly progresses into something that can take even the most elite and highly trained athlete out of all sports. It is very common in runners and cyclists.

What is Iliotibial Band Syndrome?

Iliotibial band site of inflammation

The iliotibial band is really a long, flat tendon that is an extension of a muscle called the Tensor Facia Lata (TFL). Two other muscles that insert into the top portion of the IT band are the Gluteus Maximus and Gluteus Medius (yep, your big butt muscles!). It runs from a bone called the Ilium, or pelvis, down the outside of your leg and attaches to the knee at the tibia (and blends with one of the quadriceps muscles called the Vastus Lateralis at Gurdy’s Tubercle).

The TFL muscle is responsible for hip flexion and abduction (lifting your leg to the side without rotation). The Gluteus Maximus and Medius muscles also play an important roll in hip abduction.

The main problem happens when the tensor facia lata muscle and IT band become tight. This causes the tendon to pull the knee out of alignment and rub on the outside of the joint. The rubbing causes irritation and swelling of the tendon, leading to a frustrating pain that seems to never go away.

What causes Iliotibial Band Syndrome?

IT band syndrome can occur because of functional (biomechanical) issues or overworked muscles.
Functional issues include things like:

• one leg being shorter than the other
• pronation (rolling) of the foot
• muscle imbalances (weak gluteal muscles) due to other injury or birth
• flat feet

Overworked muscles can happen by:

• running on concave surfaces, which actually causes one leg to become shorter for a prolonged period of time
• weak gluteus muscles, causing the tensor facia lata muscle to overwork and pull the IT band tight
• increasing exercise intensity or duration too quickly
• improperly fit bicycle or running shoes
• excessive circular track running (strengthening the inside leg due to the angle of the body)

What to do about Iliotibial Band Syndrome?

First, be sure to remove or reduce the cause of the problem, be it an overuse or functional problem. This may include:

• stopping or reducing activities
• purchasing new equipment
• changing your workout – consider water and non-weight baring activities
• side stretching (see below)
• strengthening the gluteal muscles
• seeking professional medical attention or sports injury education

From there, the immediate treatment is basically the same as for any injury – rest, ice, compression and elevation for 48 to 72 hours.

Then you MUST look for ongoing treatment and prevention or the injury will reoccur and could progress into a debilitating chronic condition.

Ongoing treatment may include:

• Positional release therapy (to release the tight hip muscles)
• Deep tissue massage for the hip, back, leg and thighs
• Instruction in proper and thorough warm up and cool down techniques to increase oxygen to the muscles
• Instruction in proper stretching techniques – you can injure yourself further with overstretching! Make sure you consult a professional trained in sports specific stretching

Side Stretch

This is one of the best stretches for the tensor fascia lata, side of the leg and back.

• Stand upright and cross one foot behind the other.
• Then lean sideways towards the foot that is behind the other. Try NOT to rotate your body.
• Hold this stretch for about 15 to 20 seconds, and then repeat it 3 to 4 times on each leg.

 

The Four Guiding Principles

I wish there was an easy way to describe this work but I have yet to come up with the 30 second “elevator pitch” that creates excitement and interest. So, for now, I write the long winded approach. It works for you left-brained people out there. For the right brained folks, I’m still trying to learn to draw on the computer!

Let me begin by saying our work is probably NOT a new idea. I know, not great for marketing, but I have never been comfortable pretending I have a new spin on a cure for the difficulties of life, or a new potion to recreate the joys. Basically, we take age old ideas and look at them in ways that are prevalent to the world, and YOUR world, today. I will give credit when and where I can to other authors and speakers.

The BodyLogic Four Guiding Principles:

1. your “body” has all the information and knowledge it needs to heal;
2. we are each made up of at least four bodies – physical, cognitive, spiritual and emotional;
3. through personalizing daily rituals, we can align these four bodies and have them achieving the same goal of balanced health;
4. once we become aware of and get to know our four bodies, we heal the stories and issues that stand in our way of living an authentic and pain-free life.

Let’s look at these principals one by one:

Your “body” has all the information and knowledge it needs to heal.

It’s that simple. Just get out of the way.

We are self healing creatures. Try it. Go nick yourself shaving and see if it heals without you having to TRY to DO anything. Magic! We don’t have to think about digesting food. Or growing our hair. Or making sure our blood gets pumped to all the parts of our body. Or getting the lymph or endocrine systems to send out antibodies and hormones. YAY! No thought! All these amazing things happen in our body just because they need to.

That said, there are times these systems don’t work. That’s when we have “an issue” or “a disease”. And outside medicine, both Western (physical medicine) and Eastern (philosophical medicine), can greatly influence our healing. Western medicine has accomplished amazing feats in helping us diagnose, prevent and even cure many diseases. But there is often a gap in treating the disease and treating the patient. Eastern medicine can provide us with incredible insight into the powers of our own bodies and spirits, but sometimes it’s okay to just take some ibuprofen for your back ache and move on.

So, how does the fact that “your body has all the information and knowledge it needs to heal” help us in this time? This is what our work is about. It’s about you getting out of your own way to LISTEN to the wisdom of your body. Your body WILL tell you what it needs, be it mediCation or mediTation.

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We are each made up of at least four bodies – physical, cognitive, spiritual and emotional.

The short version is we are made up of four distinct, dependent and interdependent, bodies. It is up for a longer discussion if we have more than four bodies, but for our purposes, we’ll simplify it to four.

The physical body pertains to the part you can touch. We were born into this world as physical beings, no matter what your belief on past or future lives. So our work is based first and foremost in the physical as it is one we all share in common and is not up for debate about existence.

The cognitive body is both the “mind” and brain. It crosses the emotional and physical bodies as it encompasses our thoughts, which arise from some mysterious place, as well as the neuromuscular connection. Our brains are pliable learning mechanisms that are always changing connections and patterns depending on our circumstances.

The spiritual body is not as tangible as the physical and cognitive and has a close connection to our emotional body. Most of the questions we ask are spiritual in nature; “How can I be happier?”; “Why do I struggle?”; “Will people like me?” The questions BodyLogic asks is more along the lines of What moves your spirit? What tickles the hair on your neck? What sends Goosebumps down your spine? What is that “something” you can’t put your finger on?

The emotional body is more like a constant shoreline, with waves coming and going in various sizes and strengths. The waves of emotion that come and go in our lives can be managed a little easier when the other bodies are aligned and moving towards similar goals. Jon Kabat-Zinn is quoted with “you can’t stop the waves, but you can learn to surf.” A friend and teacher of mine, Tobin Giblin, wrote a book with that title “The Art of Mindful Living: You can’t stop the waves, but you can learn to surf.” To stay within our scope of practice, we look at the emotional body as watching the waves and figuring out how you’ll plan to surf.

The four body concept is discussed in further detail at [insert blog post here].

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Through personalizing daily rituals, we can align these four bodies and have them achieving the same goal of balanced health.

This is the heart of our work. Our western culture is very limited in our range of emotional expression and we tend to put spirituality as something outside of ourselves. We do this either because of our lack of rituals and rites of passage, or we have a lack of rituals and rites of passage because we do not express the full range of our selves. Chicken or the Egg?

By bringing full rituals back into our lives, and personalizing them so that they are do-able every day or many times a day, we will begin to find an ease to life; a pattern that does not mimic monotony or boredom, but that creates a safe and predictable environment in which we can express.

Another way to look at this is the daily creation and destruction and re-creation of life. We used to do it all the time as children; build a fortress only to tear it down; build a castle only to have the “dump truck” ram it over so we could rebuild. In some eastern cultures, their whole day is a ritual of creating offerings to the gods, only to have nature or animals tear down the offerings. It’s seen as part of life. Creating an offering as the ritual, then LETTING GO of the outcome so that the Universe/God/friends can receive the offering in whatever way they want.

So, part of the program at BodyLogic is to figure out how to simplify the rituals of creation and destruction in your life so that all of your four bodies participate fully. This is where we start to see balance and a balanced health.

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Once we become aware of and get to know our four bodies, we heal the stories and issues that stand in our way of living an authentic and pain-free life.

Easier said than done, yes, but this is the ongoing part of our work called: Life. Once you learn to slow down and listen to the subtle callings of each of your four bodies, you will learn that each body has it’s own voice and each voice will figure out a way to let you know when that body out of balance. Some days this is as easy as eating a healthy lunch. Some days it is complex and confusing as you may face life threatening issues. But the answer is always the same: Take time to listen. Then take time to act. Rinse. Repeat.

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