http-equiv='refresh'/> Global Therapies: Update on ITBS

Saturday, 26 November 2011

Update on ITBS

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Thanks to whoever the Anonymous poster on the ITBS post was saying you should NEVER foam roller your ITB... an interesting point which I shall get to in a bit. I'm glad that they commented, because the post does need a little bit of updating.
I somewhat arrogantly stated that THE reason for ITBS is lack of musculature/ strength in the deep 6 rotators. Now this is indeed true, but it is not the ONLY reason for friction to occur down on the knee.

First of all, lets clear something up.
Illiotibial Band (Friction) Syndrome is actually caused by the LENGTHENING of the ITB. Yes, I wrote that correctly. Generally, the Tensor Fascia Latae- as mentioned in the previous post- the muscle that attaches to the ITB- and tensions it, becomes shortened- and as that becomes shortened, it pulls on the ITB - making it LONGER and causing it to become tighter along its whole length - but the key is that it is long and tight.

This is where the anonymous post comes in - if your ITB is already Long and Tight, why would you even consider lengthening it by rolling on it? Exactly. You wouldn't want to lengthen it any more. Its plainly not a good idea.
As for NEVER foam rollering it - I'm not so sure - if you are rollering your Vastus Lateralis - the quad on the far outside of the leg - which I often have cause to do - where exactly does the Vastus Lat stop and the ITB start? You can't really say - simply because the structures exist in 3 dimensions and in order to get to the whole of the tissue I am trying to roll out, I have to roll on the ITB.

So. There is a reason for not rollering your ITB if you have friction syndrome, but its pretty naive to say you should NEVER roll on the ITB.

I say, if it gives you a little relief, by all means go for it, but you should really be focusing on strengthening other structures around the hip which will stop you getting pain from the dreaded ITBS.

As already mentioned, it could be weak lateral rotators.
It could be (and is more likely to be) weakness in the Glutes (glute max and med)
It could be that your adductors (muscles on the inside of the leg) are too tight and are INHIBITING your Glutes- causing the tensor fascia latae to shorten.
It could be that the arch of your foot is flattening more than is optimal (some people might call this over-pronating) which is causing the tibia to torsion medially (rotate inward) causing the ITB to lengthen and create friction around the knee.
It could be that a nerve root in your spine is trapped and is inhibiting nervous signals to the glutes, bringing you back to the shortened tensor fascia latae.
It could be that the hips (innominate and sacrum) are slightly out of alignment and this is causing a biomechanical imbalance, the weak point being your knee - and thus causing pain.

It could be any number of things.
The vast majority of people I have seen with ITB friction syndrome have issues with deep rotators and glutes that don't fire properly.
Don't run on only half the muscles in your legs- practice firing those glutes- clench your butt! More to come on that later.

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