What Is IT Band Syndrome & Why You Shouldn’t Stretch It

IT Band Syndrome causing your hip and knee problems? In this video today we’ll be talking about what the symptoms of IT Band Syndrome are, what is causing IT Band Syndrome, how to find it on yourself and what the common treatments are for IT Band Syndrome.

I’m Dr. David Middaugh, and I’m a specialist physical therapist at El Paso Manual Physical Therapy. This channel is dedicated to helping people stay healthy, active and mobile, while avoiding unnecessary surgery, injections and medications.

So let’s get into IT Band Syndrome. The most common symptoms of IT Band Syndrome are outer hip pain, and outer knee pain and pain in the area in between. Let me just show you what I mean. On the outside of the hip right about where the front pocket is on your pants or your jeans. Right there, there’s a muscle called the TfL.

I’ll show you a picture in a minute. That caught that attaches into the IT band which runs on the outer part of the thigh, this outer part of the thigh can also get painful and tight and stiff. And the most common symptom is probably down on the outside of the knee, it can be a little bit below the knee joint, right on the knee joints are a little above the knee joints as well.

This is what we would call it bad syndrome, or also Runner’s knee, it tends to become worse after being more active. Sometimes this happens to cyclists in addition to runners and people that are lifting weights. And sometimes it happens to people that aren’t even doing any of those activities, they just begin to get it because of the way that they’re using their muscles in their body, which I’ll tell you more about here in a second.

If this is left untreated, of course, it can become worse to where it can be debilitating in the short term anyway, in the long term. If this problem stays there, what people tend to do is they rest so that the symptoms can go down. And they kind of give up doing that as the activity they like to do the walking, running, cycling or weightlifting. But the root problem is still there, and it’s causing their joints up in their hips and in their knees to become injured over time.

It can lead to arthritis, meniscus tears and back problems things like disc herniations in the back. So how does IT Band Syndrome happen? What is the cause of it? Well, let me show you on the whiteboard here. drawing of the IT band and the bones and muscles around it because they matter quite a bit.

So here’s the IT band in purple, you’ve got this pink muscle right here called the tensor fascia Lata TfL. And then in orange back here, you’ve got the gluteus glute muscles, gluteus medius, minimus, and Maximus. And what you’ve got to know is they both attach into the IT band and that it band, which is a thick, dense ligament or tendon like structure that runs down into the knee joint and attaches to the shin bone right at the top of the shin bone at the bottom part of the knee joint.

This is important because what happens up here from these muscle groups influences the size of the thigh and into the the knee joint itself. It can shorten this muscle record can shorten which pulls the IT band. The teabag itself won’t short notes. I’ll speak to that in a minute. But the TfL muscle can pool in such a way that it causes the IT band to shorten and go upwards and increase the pressures right here in the knee joint and also in the ball and socket joint of the hip.

Now what you need to know is as far as how this happens, there’s usually a muscle imbalance which means that there’s muscles on one side of the body that are a little stronger than the other side of the body, they’re weaker. And that changes the way that the forces occur on a specific thing in the body, in this case, the IT band and through a chain reaction of events that can begin to affect a knee joint or hip joint. And of course it comes on with certain activity.

That’s one of the symptoms. Usually with runners, cyclists and weightlifters, they’re using their legs quite a bit repeatedly over time. And if they’ve got this root underlying muscle imbalance problem, then they’re going to make it worse if they’re if they’re tending to use their TfL muscle, that pink one that’s towards the front of the hip about where your front pocket would be, then you’re going to be pulling that IT band up quite a bit, which irritates things down at the knee.

And especially if you’re having to bend your knee quite a bit like you would with running or cycling or if you’re doing leg exercises, when you weight lift, it’s going to irritate either at the hip or the knee joint or anywhere in between where that it bend is.

Now what I want to stress to you is if you’re not a runner, cyclists or weightlifter, you can still get this we see this happen all the time and non athletic people, people that are just you know doing housework, working a normal job or just aren’t as active in those specific activities that I mentioned.

If you’re on your feet quite a bit, say you go on a trip or a vacation and you’re sightseeing, or you’re just busy at home on your feet quite a bit, you can develop IT Band Syndrome as well. And what you need to know about it is I’ve never heard of anybody ever having a surgery for this. So that’s good news.

But people do get injections and take pain medications for this. And there’s other treatments that I’ll speak more about in a moment. One of the biggest questions I want to answer though, regarding treatments, and I want to just hang on for a bit is stretching.

Everybody loves to stretch it bad, especially health care providers, physical therapists, doctors, other sports medicine or health related people love to give people with IT Band Syndrome stretches in order to begin to treat the IT band problem. And the truth is that we have taken cadavers, we’ve taken dead people and cut out their it bands, hung them up and hung weights on them and measured the stretching that happens in the it bends over time. And it really doesn’t stretch.

It’s not a contractile tissue meaning sound like muscle where it has the ability to short and lengthen, it really is a tough material, so it can’t be stretched out. So the thought of stretching your IT band, as a treatment option is just kind of ludicrous. Really what you’re stretching out is the things that attach to the IT band like the TfL muscle, that’s the main one.

So if you go to aggressively stretch your TfL muscle, there’s a reflex in muscles called the stretch reflex, you can look this up, you can type it in YouTube, or Google. And what you’ll find is that when you aggressively stretch a muscle, it actually wants to contract and wants to work, which means it’s going to shorten and stretch other things around at the tendons, the ligaments nearby.

So stretching your IT band for treatment for IT Band Syndrome actually becomes part of the problem, you actually will feed into the IT Band Syndrome because you’ll make that TfL muscle stronger over time. This is the reason why the IT Band Syndrome happened in the first place the runner’s knee, this is why you’re getting pain in your hip or your knee or anywhere in between.

So it is not a good idea to be stretching your IT band because you’re stretching your TfL which is making the whole situation worse over time. If you want long term relief from an IT band problem, then you’ve got to do something else besides stretching.

So that leads me to my next question, what should I do instead of stretching for it bad treatment, the number one thing that is recommended for sure by me by specialists, physical therapists that know about muscle imbalances and how to solve things naturally for the long term is specific exercise in this muscle imbalance.

We’ve got to fix the weakness which is glute muscles. That’s why I drew the glute muscles right here on this picture in orange. If you can strengthen these glute muscles, the causes that TfL to calm down and relax that purple IT band which takes pressures off down at the knee joints, and and up at the hips as well. Using your glute muscles is foundational for so many things. It really is a panacea fix all for a lot of hip, knee and back problems even down in the ankle and foot.

It can help out tremendously with problems down there. I’ve made a video specifically talking about the two key exercises that you need to be doing for IT Band Syndrome. It’s linked in the description below. I’ve also included in there the two stretches that everybody likes to give out and try for it man syndrome, the ones that you shouldn’t be doing.

And the second thing that I recommend it for IT Band Syndrome is foam rolling, which in that same video that I just mentioned on LinkedIn, there’s a piece in there about foam rolling, just make sure you watch the video till the end and what are the treatment options are out there for it man syndrome, I can tell you the most common things that people do which help in the short term, it’s okay to do this.

But if you’re thinking about fixing it for the long term, go back and check out that video that I mentioned in the short-term putting ice on your IT Band Syndrome problem wherever it hurts is a good thing. It’s better than taking pain medications for sure. And going to the doctor for an injection or the high-power pain medications that they can prescribe you.

A lot of people actually manage pretty well with ice for most knee problems and it man syndrome is one of those. It’s just that the knee is everything’s kind of packed in and it’s easy to get ice and cold into the layers that need it. So putting ice on your knee is going to be fantastic. If you have to take pain medications definitely start with something over the counter.

Something that you know has worked for you in the past or that your doctors told you is okay for you to take in, go to the local pharmacy and check out what over the counter pain medications might work best for you. Other advice to doctors and other physical therapists often gives their patients for IT Band Syndrome is resting it which means basically stopped doing the exercise that bothered you or that activity that bothered you.

And this is a good thing in the short term because if especially if you have any swelling, or if it’s just so irritating, you can’t get comfortable at night. You can’t get comfortable with just sitting around for a while resting. It is Good things, they bring that irritation down. The problem with resting it is if you don’t fix that muscle imbalance, as soon as you get active again, it tends to come back.

And the more extreme version of resting It is sometimes health care professionals will tell you to quit doing that thing that you’re doing. So if you’re a runner, and you have that medical professional telling you, you need to stop running, it’s just a killer for you is just a punch in the gut. Same thing if you’re a cyclist, most cyclists just love cycling.

I mean, I’m a cyclist, myself, I love to run to is just tough to hear somebody who’s got a medical type degree some health care degree, tell you that you should not be doing that. Especially if you don’t know any better. I’m telling you right now that it can be fixed, you can get back to running and cycling and weightlifting easier.

The ones that people will say you shouldn’t be squatting all that weight or deadlifting all that weight. I completely disagree. I think that you should learn how to run by can squat or deadlift, whatever weight lift activities, whatever weightlifting activities like to do, learn how to do them with your glutes better, which we’ve got tons of video on our channel about, then you can keep doing those things without getting this Runner’s knee or this IT Band Syndrome problem coming back.

But of course, physicians are specialists in medicine. So that’s what they want to do for you because that’s what they went to school for. So they’re going to recommend giving you an injection at the knee joints or at the hip joint depending on where your pain is worse. And of course, they’ll give you prescription level pain medications, if that’s something that you want. I hope this video was helpful for you.

If you’re in the El Paso, Texas area, and you’re thinking you’d like us to take a look at your problem to see if there’s a chance that we can help you out in person we’d love to explore that opportunity. All you got to do is apply for a free discovery visit you got to scroll down to the bottom of the page here and find the button that says apply for a free 20 minute discovery visit.

Once you hit that button, a formal pop up you just need your details. And once you submit that my staff will call you back as soon as possible to let you know when the next steps about applying for a discovery visit and possibly scheduling that appointment.

That appointment is a 20 minute visit with the specialist physical therapist we’ll take a look at your problem in person. We could do it over a video call as well if you prefer to do a telehealth call. And once we finished checking you out and hearing your story about from when it began to what it’s become now your hip pain, your knee pain, then we’ll give you a diagnosis and let you ask all the questions you need so that you can understand about what’s going on in your hip and knee problem.

So you can make the best decision moving forward about it. I’ve got to do is apply for that free discovery visit. Again just scroll to the bottom of the page and hit that button to get going on that. I wish you the best of luck and I hope that we can be a part of your success story really soon. Bye.