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IT Band Pain Part 2 - Debunking Common Myths


In Part 1 of this series we talked about what Iliotibial (IT) Band pain is and the risk factors for developing it. In this blog post we will briefly discuss the common myths associated with this condition to further deepen the reader’s understanding.


Myth #1

Stretching the IT Band is important for recovery or prevention of IT Band pain -

We once thought that the IT Band could be stretched; however, this does not seem to be the case. A recent study showed no effect with stretching on short-term IT Band stiffness (2).



Even if we could change the length of the IT Band through stretching, it may not make sense to do so. Runners making a successful recovery from IT Band pain actually show increased stiffness in the IT Band, similar to individuals recovering from tendon injury. This increased stiffness is a favorable adaptation and something we are trying to achieve with the rehabilitation process.





Myth #2

Foam rolling will help my IT Band -

This is a similar discussion to the previous myth. The aforementioned study also looked at foam rolling the IT Band and found no difference in short-term stiffness. And again, a decrease in stiffness likely is not favorable.


IT Band pain also seems to be a compressive issue. Adding more compression is counterproductive.


Myth #3

Deep tissue massage or Instrument Assisted Soft tissue Mobilization (IASTM) will help with recovery -

A common thought is that deep tissue massage or IASTM will break up scar tissue or adhesions and loosen the IT Band. This makes sense in theory, but unfortunately does not play out in real life. And again, we want more stiffness in the IT Band during the recovery process so even if we could slacken the IT Band, why would we?



You may feel better initially with foam rolling, deep tissue massage, or IASTM; however, we are confident that this temporary decrease in pain is related to central desentization and is only transient, typically lasting for one hour or at most 24 hours. Let’s use this analogy as an example…The volume on your stereo is set to level 10. Your kid comes in and cranks it up to level 20! You request that he or she turn it back down to level 10 and now, level 10, seems quieter than before. Here’s a paper that describes this phenomenon.


Myth #4

I’ll just rest and it will get better -

As discussed in part I of this series, total rest is not the answer. This may be appropriate in the very short term as the sharp pain subsides, but by completely resting the runner is unknowingly causing the IT Band to lose even more load capacity.


Avoidance of loading the sensitive structure is also known as stress shielding, and is the incorrect way of going about rehabbing the IT Band.


Here’s how the cycle plays out – Injury occurs – runner offloads the IT Band, and unknowingly loses capacity – runner now has decreased or no pain – runner returns to running too quickly – re-injury/re-exacerbation occurs.










Figure 3: Cycle of loss of load capacity (taken from Dr. Rich Willy Etiology & Assessment)



Myth #5

LOCATION. LOCATION. LOCATION. IT Band is a hip and lateral thigh problem -

This is in fact, incorrect. Many think because the IT Band courses the length of the lateral glute and thigh, that pain in this region is associated with the IT Band. IT Band pain is characterized by localized pain at the lateral knee, hence the name, “Runner’s Knee.”



Myth #6

My IT Band is INFLAMED so I need ice and NSAIDs -

This is a logical thought, because something in that region is clearly irritated. However, we now know that inflammation is not the driving factor for IT Band pain. With inflammatory conditions, immune cells are always present, and with IT Band pain these immune cells are absent.




We hope this article was informative and helped clear up any misinformation you may have received in the past. Don’t forget to share this with a friend to help save time and money spent on ineffective treatment.

We successfully help runners and other athletes recover from IT Band pain all the time! If you need guidance in recovering from an injury, schedule an appointment, and we’ll help you get back to doing the things you love!



References:

  1. Aboodarda, S. J., Spence, A. J., & Button, D. C. (2015). Pain pressure threshold of a muscle tender spot increases following local and non-local rolling massage. BMC Musculoskeletal Disorders, 16(1). https://doi.org/10.1186/s12891-015-0729-5

  2. Pepper, T. M., Brismée, J.-M., Sizer Jr, P. S., Kapila, J., Seeber, G. H., Huggins, C. A., & Hooper, T. L. (2021). The immediate effects of foam rolling and stretching on iliotibial band stiffness: A randomized controlled trial. International Journal of Sports Physical Therapy, 16(3). https://doi.org/10.26603/001c.23606



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