The IT band is a thick band of fascia that runs between the gluteus maximus & tensor fascia latae and down to the upper lateral part of the tibia. It's also the site of one of the most typical spots for "pain" in runners.
The glute max has a lot of thick and dense connective tissue that blends into the lateral fibers of the IT band. Continuing up the chain, the fascia that connects through the glutes also crosses your SI joint and your low back. So you can see how a stressed IT band can also manifest itself in low back and hip dysfunction. When it gets tight, all these tissues causes the spine, hip and knee to become misaligned.
Runners end up with a lot of IT band problems because of improper mechanical alignment during running, mostly due to fatigue (sped up by improper breathing mechanics, below is a video addressing how you're supposed to breathe). Thus they continue running until near failure and create a faulty running stride.
Once fatigue sets in, long distance runners beat up their IT bands because of pronation (your foot rolling in). This then creates internal rotation at the tibia and your femur and then stretches out the glute muscles all of which increase the tension that's being applied to the IT band. Your IT band fights this as long as it can, and eventually will succumb to the constant repetitive stress. This is why when you're running you may experience sharp lateral pains and the lateral area of your quad feels like it's made out of metal.
Your IT band is trying to prevent misalignment and dysfunctional movement at the knee and hip. It decelerates rotation that occurs during a faulty foot strike and/or a lack of strength at the hip stabilizers. The knee, which should only move in one direction, has very little rotational movement and thus the majority of the force being produced by the quads and hamstrings, the IT band and glutes complex has to work together to stabilize against these movements.
Muscles regenerate at a much quicker pace, which is why you can recover from a really hard workout within a few days. The problem we run into is that your ligaments and tendons which the IT band resembles, take much longer to adapt and regenerate from exercise and misuse. Whereas your glutes can get strong pretty quickly, chronically stressed tissues could take a few weeks to hit the same level of adaptation. This is one reason why de-load weeks are a good idea to include in your programs. You may feel absolutely fantastic for a run, but sticking to the de-load protocol allows lower levels of stress to allow some catch-up for the tissues to adapt to the strength levels of your muscles.
IT band issues aren’t typically a big deal unless you leave them unattended without some soft tissue work for an extended period. This usually results in some tenderness, reduced ability to flex the knee without pain, or some form of aching on the lateral thigh; coupled with trigger points around the hip or lower thigh along the lateral line which is easily the most painful trigger point in the body. Spots to hit: Quadriceps (more toward the outside) TFL, and glutes.
Once given a chance to recover, hit it with a roller, and strengthen the plantar muscles so you may reposition your foot (if you’re a pronator). The issue typically goes away, at least until it gets over-stressed again. Then it’s just a matter of being diligent on maintanence and continuing to strengthen the glutes and hip stabilizer muscles. Hit the roller to start the workout, as needed after the workout, and IT band issues should be minimal.
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