Iliotibial Band Syndrome
Ruptured ACL
Healthy vs. Torn ACL
Ligaments of the Knee
ITBS is a chronic cycle of healing, followed by more injury, in the Iliotibial Band.
Exercise only after you are well into the healing process.
If you exercise and it makes the pain worse, stop immediately to avoid making your ITBS worse.
Iliotibial Band Syndrome (ITBS) is an overuse injury most often impacting athletes.
It can be severe enough to force you to take time off from physical activities due to pain.
It can also be tricky to heal once it gets going.
This is because it is a cycle of injury leading to inflammation, which leads to more injury, and so on.
But you can heal ITBS if you take the right steps.
Iliotibial Band Syndrome is one of those subjects where the internet is full of bad advice that will make the condition worse.
This is very true of the suggestions about exercise.
It's important to understand the role of exercise for ITBS, when you should do it, and more importantly when you should not exercise.
Exercise at the wrong time will very likely make it worse.
ITBS is an injury caused by the IT Band repeatedly rubbing back and forth across a bone during heavy activity.
The IT Band is a long tendon traveling down the side of the leg.
It connects at the muscles of the hips and buttock and reaches down to just below the knee.
The muscles of the butt and hip pull on the IT Band like a rope to move the leg forward or to the side.
When your leg goes from straight at the knee to a little bit bent, it drags this tendon across a bone.
Normally this is not a problem, but if it happens enough times under a heavy load, ITBS can develop.
In some people it happens at the hip, instead of the knee, when the upper leg goes from behind the hip to ahead of the hip, and the tendon wears against the hip bone.
For many people it just feels like the whole band is on fire.
The IT Band is very robust, so it takes a lot to get this condition going.
But once you do it, it can be challenging to get out of the reinjury cycle and start the healing process.
You can heal ITBS if you know the right steps and understand what not to do.
You will see sites online suggesting exercise to fix your ITBS. Your doctor might suggest it or send you to physiotherapy to get specific exercise treatments. But is it really the best way to heal your ITBS? Proponents of exercise for ITBS always point to either blood flow, relaxing the IT Band or, fixing muscle imbalances as the reason.
Yes, blood flow does speed up healing of injured tissue.
But first you need to deal with the issue of inflammation.
Your IT Band has rubbed on the bone beneath it and that has led to an injured place on the underside of your IT Band.
This causes swelling right at the injury location which makes it rub against the bone even more with even the lightest exercise.
To get this injury to heal, you need to first reduce the inflammation.
You need to rest the area, use cold therapy to reduce inflammation, and protect the injury with medical tape (not kinesiology tape).
While you are reducing the inflammation, and you are protecting the damaged IT Band from reinjury, you can work on blood flow.
But you have to get blood flow to the area without doing something that simply moves the IT Band back and forth over the bone.
Even light exercise can aggravate the condition further when it's severe.
This just keeps the cycle going.
What about muscle imbalance?
Don't we need to fix that?
Some sites will say that muscle imbalance plays a role in why some people get ITBS in the first place.
But more heavy exercise is not how you fix the condition!
Before you "fix the imbalance", you have to get out of the injury stage.
Once the injury is well down the road to healing, then you can address any muscle imbalances to help prevent the problem again.
Muscle imbalance is a highly unlikely thing to happen unless you are lifting weights in a gym and only exercising a restricted group of muscles.
Most people, though have a balanced gym routine so this is unlikely.
And for people who are mainly active in sports, you can trust that your body will build your muscles in a balanced fashion for the activity you like to do.
Maybe you think your muscles are unbalanced for some reason.
Plan to exercise to correct the imbalance, but you need to do this after you have healed the injury.
If you try to correct this imbalance while this injury is aggravated and inflamed, it will only make it worse.
To heal the irritated and inflamed spot on your IT Band you need rest and your body will do the rest.
If you have to move around much at all then tape your IT Band to protect it and always use cold compression on the area after your activity.
Bottom line, to heal this condition you want to reduce the swelling, protect the area from further injury, and perhaps get nutrients to the tendon with blood flow stimulation therapy.
The compression band has to be the worst advice for this condition. But you can find it everywhere online. Those sellers on Amazon are there to make money at your expense. Various websites suggest to exercise while wearing this 'special' ITBS compression band at the same time to "protect" the injury. There is no worse advice. Compression bands actually make the IT Band even tighter against the bones, causing it to rub even more. And that tightness is all focused right on the spot where you have the injury. Adding exercise movements will make the IT Band wear against the bone. Do not do this.
Save yourself the pain and aggravation.
If you have to move around very much tape the injury.
But do not use a compression band.
The best protection is to make an "X" with tape right over the spot where it hurts.
Use proper Medical Tape not "Athletic" or "Kinesiology" tape.
You need to be taped up the whole day if you have to work and your work requires you to be on your feet.
Even the big name Athletic tape products have toxic chemicals in the glue that will be on your skin all day.
Make sure you use a high quality option like King Brand Medical Tape.
Medical tape is designed to be worn all day every day and will protect your skin from damage while helping your IT Band heal.
Medical Tape is like armor for an injury and a much better option than something like a compression band.
If you want the next-level of healing, you can also get blood flow stimulation (diathermic) devices for the area.
These devices increase blood flow in deep tissue without exercising or stretching.
Ultrasound is an example of a diathermic device that can increase blood flow without exercise.
But most people don't have ready access to Ultrasound.
Anyone can get and use BFST wrap, a home diathermic device, to increase blood flow to damaged tissues.
It's easy and you can do it at home.
This is a great way to get your Iliotibial Band Syndrome healing quickly.
Diathermy is not necessary for most ITBS cases though.
In most cases, it is used just for people who need to heal more quickly or haven't been able to get past the condition with a more conservative approach.
This is a common idea with lots of injuries. Something is tight? Stretch it. The idea is that it will relax the hip and buttock muscles that are pulling on the IT Band and making it tight. Many 'experts' suggest that stretching these muscles will make the IT Band 'more loose'. This does not make sense though. Yes, stretching may mean your IT Band is less tight when you are at rest. But when you are at rest, you aren't doing any reinjury to your IT Band. As soon as you do any activity, the muscles will still pull as hard as needed on the IT Band to move the leg and keep you stable.
Stretching isn't bad.
In many cases it increases your muscles' range of motion and that's not a bad thing.
It just won't help your injured IT Band.
ITBS isn't a range of motion kind of problem.
Really, the area just needs enough time to heal and for the inflammation to subside.
If you enjoy stretching, it's not likely to make your condition worse, so enjoy it as much as you like.
For a little while - not forever - it is really helpful to give your Iliotibial Band a rest. In many cases, resting your leg for a few weeks will give it time to heal to a point that your body gets ahead of the healing / reinjury cycle. It's important to realize that once the pain and any swelling go away, your underlying injury will not be healed completely, so take it easy. Go back to regular life gradually, once the pain and swelling are gone.
