Iliotibial Band Syndrome
Ruptured ACL
Healthy vs. Torn ACL
Ligaments of the Knee
Iliotibial Band Syndrome (ITBS) is an overuse injury most often impacting runners and other athletes.
If your ITBS is severe enough, it can force you to take time off from physical activity due to pain.
But you can heal your IT Band quickly by avoiding common mistakes and taking the right healing steps.
Iliotibial Band Syndrome is one of the most poorly explained injuries on the web.
Even the top medical sites online, will waste your time with useless anatomy descriptions that really don't help you understand this condition.
To make matters worse the vast majority of the recommendations for treatment will prolong or intensify the condition.
Let's look at what ITBS really is, without all the medical jargon, and how to rapidly heal it once and for all.
What is the Iliotibial band?
The IT Band is a super long tendon that runs down the side of the thigh.
It connects the muscles in your buttocks and muscles in your hips down to your leg bone, just below the knee.
You can think of this tendon like a long rope running down the outside of the thigh.
Your buttock muscles and the muscles on the front of the hip connect to this rope and use it to pull your leg bone for certain motions.
The most powerful motions are either backward and to the side like in a skating motion, or frontward and to the side as in a karate kick.
Now you might not be doing those motions when you feel the pain.
To some extent, your body engages those muscles bones and tendons pretty much anytime you walk or run as it provides stability to your motion.
The very strong muscles pulling the IT Band or "rope" create a lot of tension.
That rope is pulled tight with every step.
The ITBS injury comes from when your leg is going from perfectly straight at the knee to just a little bit bent.
During that motion, that tendon slides across a bony protrusion on the outside of your knee.
Normally that isn't an issue but, if it happens a lot under a lot of load, it can get irritated after some time.
When it's irritated, the tissue around it swells.
When it swells the space gets tighter to the point that any motion of the tendon across that area causes the condition to get worse.
Some people may experience the rubbing up at the hip area.
A similar situation happens there.
And you could have it in both places but this is less common.
The IT Band and the bones and muscles involved are quite robust and built for repetitive motion.
Before the injury, and again, eventually, after it heals, your body is designed to handle the activity.
You just had some bad luck that this condition developed.
But what happened?
It takes a lot of strain to get this condition going.
Light repetitive motion like walking is not what caused it, even if it was for a long time.
But, if you engaged in an activity causing a lot of strain for a long period you can end up with a very inflamed and irritated IT Band.
When you describe the symptoms to your doctor, they will say you now have Iliotibial Band Syndrome.
It is often called ITBS, ITB Syndrome or IT Band Syndrome.
These are all the same thing.
I*t's an irritation and swelling of the long tendon in the side of the leg.
Bottom line, to heal this condition you need to rest.
If you want to be proactive and heal a bit more quickly, you can reduce the swelling and protect the area from further injury.
If you want to be super-proactive you can use diathermy on the tendon to stimulate blood flow.
Simple enough?
Did you notice there was no mention of special exercises, medication, massage, or "regenerative medicine"?
No, you don't need injections, or chiropractic adjustments.
You don't need to spend thousands of dollars on "treatments".
You need to let it rest a bit and get some blood flow to the area so it can heal.
But do it the right way.
The majority of advice on the web will make it worse.
For more information on Proactive Treatments, you can click this link.
Most people have stinging pain on the outside of the leg just above the knee. This is a point where the IT band can rub against the bone. Sometimes though the pain will radiate up the thigh. A smaller amount of people will experience the initial rubbing of the tendon on bone at the hip and the pain and irritation will start there.
You probably know what happened to start this condition in the first place.
Maybe it was basketball or roller blading.
It is common with sports that require quick repetitive sideways motions.
Skating is a prime example.
Sometimes it happens to people from running downhill because the legs go stiff and straight a lot of the time.
Especially if they are moving to the side on the way down.
Each downward step puts a lot of pressure on the IT Band and over time this can cause irritation.
The injury occurs when your leg goes from straight to bent, or bent to straight over and over again under strain.
If your pain is near the knee, it's where the knee went between straight and bent.
If your pain is up by the hip, then it's when your hip and leg went between bent and straight over and over again with a lot of strain.
Ultimately, it does not really matter how it started.
You will need to take time off from whatever causes you to feel the pain now, and generally take it easy on the area.
There are 3 Key Factors:
1. The severity of your injury.
2. The amount of reinjury you do.
3. Proactive treatments you apply.
What people really want to know is, "When will the pain be gone and I can return to normal life?".
That's very different than when your tissue is actually fully healed.
Long before the ITBS is fully healed, you will be doing most of what you could do before.
If it's a very minor injury to the Iliotibial Band then most of the pain can be gone in 2-3 weeks and the condition can heal in 4 or 5 weeks.
If it's a moderate injury of the IT Band then it can take 4 to 6 weeks to fully heal.
For a major injury, with lots of swelling and inflammation it can take 8-10 weeks to fully heal.
At this point, people want to know what they can do to speed up the process.
There are definitely things you can do to proactively speed the healing process.
You don't have to do them but athletes and those who want to shorten the healing time as much as possible will use diathermic processes like BFST and Ultrasound.
It will heal on its own, even without those proactive steps.
It will just take longer.
The short-list of things to avoid are to not drive through the pain, avoid using painkillers, and avoid exercising and stretching that can make the situation worse. As long as you are still in the painful stage, stretching is bad, not good. Physiotherapy is also for after you get past the painful period - it's good then, but it can be damaging if started too soon. If you aren't happy with the best-case healing times, don't do things that are going to drag out the injury.
Rest is the first step to healing this injury.
Next use cold therapy to reduce pain and bring down the inflammation in the painful area.
Cold therapy pulls the pain out of the injury super fast and does not mask the pain.
Caution: There's a big temptation to take a bunch of pain meds for this injury because it hurts quite a bit. Don't do that if you can avoid it. The biggest reason is it does not help the tissues heal at all, and masks the pain, making it more likely that the condition will get worse.
If you use cold therapy regularly, you can reduce the inflammation and give it a chance to heal.
Wearing a cold pack on the area for longer periods of time can help this happen.
You need a type of cold pack that distributes the cold energy evenly and is just the right temperature.
Which is just above freezing.
The pack needs to stay in that safe and effective temperature zone for extended periods.
Ice pack injuries are common.
A proper gel pack, like ColdCure, will take the inflammation and pain right out without risk of "cold burns".
Don't use cold right before activity.
But always use it right after activity, even if it does not hurt at that time.
Any activity will increase inflammation, and the cold will reduce that inflammation.
This way, you can exit the cycle of the swelling, which can lead to more injury.
Next tape the area.
You have to avoid reinjury.
This is critical.
If you get the inflammation down and then just go right back to irritating the IT Band you will undo any progress.
There is a reason pro athletes use tape. It works.
When you tape an injury, you keep the skin under the tape from moving.
This reduces the amount of movement in the injured tissues below the skin.
This works remarkably well for protecting damaged tissues.
It's like armor for your injury.
If you want to take treatments to the next level, get blood flow to the area using diathermy.
Ultrasound is an example of diathermy that can increase blood flow without exercise.
But most people don't have ready access to Ultrasound.
Anyone, though, can use BFST to increase blood flow to damaged tissues.
It's easy and you can do it at home.
This is the fastest way to get your Iliotibial Band Syndrome healing quickly.
This is one of those injuries where the internet is rife with bad advice. Here is a breakdown of some of the most common things to avoid. But it's not a complete list. So notice the common theme. You need to let this injury rest. You want to reduce inflammation in healthy way that does not increase your chance of making the condition worse. And you want to avoid anything that is causing more pain, because this means you are stopping your body from healing your ITBS.
There are lots of compression bands that are sold as a solution for ITBS. They are very common on Amazon and heavily promoted in videos and sites looking to sell them to people with ITBS. But do they work? The idea is that by holding the pressure on the injured tissue you will protect it and keep it from moving too much. Some sites also suggest that the compression will keep the area from swelling.
In reality, the ITBS Compression Bands just make the condition worse. The problem with ITBS Compression bands is, they apply intense pressure precisely in the location where the tight IT Band is rubbing against the bone. They just make the tight spot tighter. Now when you bend and straighten the knee you have even more tightness and pressure on those already damaged tissues. Not a good idea. These bands do not reduce inflammation as they often claim.
Instead, use cold compression to reduce pain and inflammation. The mild and even compression, combined with cold, will dramatically lower pain levels and inflammation quickly. Then, use tape to protect the area from further injury. Tape provides just the right amount of restriction of movement in the damaged tissues. Tape does not wrap all the way around the knee, causing excessive restriction and binding of the damaged tissues like a compression band does. Just run a strip of tape right over the painful area. Make an X with the tape right where the pain is and you will be amazed at how much more stable the area feels immediately.
When you stabilize the damaged tissues and reduce movement, you protect the area. This helps give your Iliotibial Band Syndrome time to heal. Combining tape and cold therapy is a fantastic way to start reducing inflammation and pain while protecting the area from further injury. Just make sure you use Medical Tape. Not sports tape. Sports tapes are not designed for extended use and you need to keep this area taped up all day while healing. Regular sports tapes often have toxic chemicals in the glues. This is common even in some big-name brands.
This one is a super common suggestion.
The idea is that it will get the area to relax and help promote blood flow to the area.
The blood flow is supposed to help reduce inflammation.
This is a nice idea, but it does not really work in practice.
The main reason is that once you have inflammation and irritation in the Iliotibial Band rubbing it with hands, or worse, a foam roller just aggravates the injury even more.
The foam roller is especially bad.
It applies a high degree of very direct stress on the Iliotibial Band.
This inevitably irritates it further and leads to a cycle of injury and reinjury.
You really need to let it rest.
That is what will get ITBS to start healing.
Cold therapy can reduce the pain and inflammation.
Taping it will help protect it when you have to move around.
Blood flow will help it heal.
And yes, massage does bring blood flow.
But at what cost?
Try a therapy like BFST instead to bring blood flow without having to move the injured tissues.
The movement of massage and exercise will only create more inflammation and keep the injury/reinjury cycle going.
Another super common suggestion you should avoid. Again, the thinking is similar. Somehow a specific magic exercise is supposed to get the irritated and inflamed Iliotibial Band to relax. But, exercise puts the already strained IT Band through more repetitions of rubbing against the bone. But the tendon rubbing on the bone is how your ITBS started. Basically, they are suggesting that by doing more of the very thing that caused the issue in the first place, that it will somehow heal you now. Save yourself this pain and focus on better ways to heal.
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. They suggest that stretching these muscles will make the IT Band more loose. This does not work because, as soon as you go back to any activity, the muscles will still pull as hard as needed on the IT Band to move the leg. And since you still have irritation and swelling in the IT Band it will still slide across the bone underneath. The whole area needs enough time to heal and for the inflammation to subside.
It is ok to take pain medication to sleep. But during the day it is best to use the pain as a reminder and let it signal you not to do things that could make your injury worse. Pain killers mask the pain and don't do anything to address the injury causing that pain. This can cause a false sense of ability that will lead to a worsened condition and much longer recovery time. If you have to take painkillers, try to restrict them to times when you're at rest. Using them when you are active is a recipe for permanent damage.
If you seek help with Iliotibial Band Syndrome, there is a remote chance you will be offered some sort of injection.
If you choose any therapy, medication, or treatment that only takes away pain and swelling temporarily then make sure you understand the pros and cons of what you are doing.
The artificial removal of the pain and swelling can lull you into a false sense that you are healed, causing you to do activities you should not do.
Often doctors don't even tell you that you should rest during this time.
They likely won't tell you that you should take other steps to heal.
They will, however, offer you another shot when you still have your ITBS later.
Steroids actually thin the tendon tissue over time and make it more vulnerable to reinjury.
This could lead to tendon rupture or the need for surgery in the future.
Protect the area with medical tape.
Athletic tape like KT tape and Rock Tape are only designed to be used for a couple hours at a time.
They have ingredients that irritate and damage your skin long term.
For your ITBS you are going to want to tape all day long, every day for a few weeks.
With that kind of use, you should only use medical grade tape.
Don't do any sports, exercise, stretching and take it easy as much as you can at work.
Give your body the time and the break it needs from activities that add stress to the injured tissues.
Just a few weeks of solid rest is probably enough to stabilize your injury and you can then start to slowly work your way back to your regular routine.
Focus on healing first.
Physiotherapists and doctors recommend stretching and strengthening exercises because it helps to promote blood flow through your injured IT Band.
Remember, it's the motion in our knee that causes the tight IT Band to rub against the bone.
When we are injured, we need to reduce our activity, and that leads to a weakening of the muscles called Atrophy.
In the early days of recovery, it is only the motion that we need to pump the joint.
We don't need to bear a lot of weight on the knee.
Really, as long as you don't feel pain, whatever activity you are doing is probably okay.
So, in the early days of recovering, the early days of PT, the key is motion, not exercise.
Physiotherapy is also intended to help strengthen the surrounding muscles to rebuild that lost muscle once you are on the mend.
But it can be harmful if heavy stretching and exercises are started too early.
Your injury first needs to stabilize, and in order to stabilize the injury you need to rest.
If you still have significant injury, any physio you do should start off very light.
Our advice is, don't start Physical Therapy until your condition has stabilized. When you start, if you feel pain during or after PT, speak up! Your clinician can't feel what you feel, so it is very important to advocate for yourself during physio. Let them know how it feels at each stage so they can use that as a guide to treat you properly. PT is not supposed to hurt and if it does you may be re-injuring your IT Band. Never drive through the pain. If your physio recommends you work through the pain you should consider a different therapist.
When you rest, your blood flow slows down which doesn't help your injury heal.
This is why BFST® is so important to start early on in your recovery.
The BFST® will increase blood flow when you can't exercise and stretch aggressively.
This enables exchange of nutrients and waste with the synovial fluid - to promote the healing process.
So, with BFST, you can have increased circulation for hours even though your actual motion of your joint is quite light and that is invaluable to your knee.
BFST stimulation also helps prevent reinjury when you become more active.
Giving your IT Band BFST therapy before any activity triggers the IT Band as though there is significant exercise going on.
Think of it as a warm-up lap for your IT Band before you actually start the exercise.
That warm-up is invaluable in preventing reinjury, particularly if you were fairly immobile before hand.
Start BFST early. The earlier the better!
Use the BFST® to warm up your leg before PT and before any other heavy activity.
This will help prevent further injury as a result of the PT activity.
At the beginning of your injury, even before the injury has had a chance to stabilize and long before you start physio, the ColdCure® Wraps will help keep the pain and swelling under control.
Cold compression is highly recommended to stabilize a fresh injury.
And when you are active, invariably, you're going to aggravate your condition to some degree.
If you're very active, you may aggravate it a lot!
After any activity where you may have aggravated your injury, use cold compression to minimize the negative impact and stabilize your IT Band.
Always use your ColdCure® wrap after any heavy activity and after PT.
The KB Support Tape™ should be applied every morning and worn all day long to help prevent re-injury, including to PT.
It protects you when you move.
KB Tape is armor for your injury.
For many people, King Brand® products, used in the comfort of your own home, are all that is required without having to attend and pay for Physical Therapy appointments.
Because you don't have to move to use them, the King Brand BFST® and ColdCure® Wraps can be started any time in your recovery process.
There are things you can do to speed up your healing.
Stabilize the injured area and protect from Reinjury with KB Support Tape™.
Use ColdCure® to reduce pain.
Use BFST® to bring blood flow to the area and speed healing.
ColdCure® will take the pain right out of the injured area.
And it will do it without dangerous pain killers and without masking the pain.
KB Support Tape will help protect the injured tissues.
It reduces how much the skin under the tape can move.
This in turn will limit the movement of the damaged tissues below the skin.
It works remarkably well.
Use only high quality medical grade tape.
Not athletic tape.
BFST will help the injured tissue heal by bringing blood flow right where it is needed most.
This way you can get all the benefit of increased blood flow to bring healing nutrients to the injured are without resorting to therapies that can be damaging like exercise or stretching.
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.
