Archive for April, 2013

Anatomy of the Iliotibial (IT) Band

Friday, April 26th, 2013

Sports Massage Therapy entails a lot of specific work. There are hundreds of sports that athletes are determined to master. But at my practice in downtown Salt Lake City, Utah, I find that athletes whom are constantly training end up with many similar injuries. One of these common injured areas includes the Iliotibial band, or IT Band.

The Iliotibial band (IT band) is a long flat fibrous band that runs all the way down the outside of the thigh connecting the Tensor Fasciae Latae muscle to the anterior tibia just below the knee. The Tensor Fasciae Latae originates from the anterior part of the outer lip of the iliac crest and from the outer surface of the anterior superior iliac spine or ASIS.

The IT band is very long and therefore plays a big part in our everyday movement. Surrounding it are some major muscles like the Gluteals, Hamstrings and Quadriceps. The tasks of the Iliotibial Band (ITB) are flexion, abduction, and medial rotation of the hip. In addition, the ITB contributes to lateral knee stabilization. I’ve always found it fascinating how the Tensor Fasciae Latae kind of turns into the Iliotibial Band, therefore acting through the band by pulling it superiorly and anteriorly. This can also be seen in the illustration.

Hopefully you now have a better understanding of the IT band and its function. But this band often baffles clients. I constantly hear questions like, “Why does the IT band always get so tight” or “What type of tissue comprises the IT band?” This second question is another subject that fascinates me.

The IT band is a different type of tissue. It’s not muscle or tendon or ligament specifically, but instead a strong, tendinous fascia. Although Tendons, Ligaments and Fascia are all made up of connective tissue, they are all slightly different. I like to think of the IT band as a mixture of very strong Tendon and Fascia. This is how I try to describe it to my clients. Because the tissue of the IT band is so thick and strong, it is likely to become very tight, especially with much activity.

So which sports are mostly likely to affect your IT band? I see Runners and bikers that struggle the most with the IT band. If you are an avid walker, hiker, jogger or marathoner, I would suggest investing in a foam roller. Foam rollers are one of the most effective ways to loosen the IT band, because it is such a hard area to stretch. Below is a demonstration of how to use this foam roller on your IT band.
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For some reason the woman in this photo has a big smile, but if you do this exercise, you won’t be smiling. It has always been a long running joke with many of my clients that the IT band always hurts because no one ever wants to stretch it out. Why is that? Because it can really hurt! But it will definitely feel better and looser after the fact, so don’t give up if you feel a little uncomfortable. You can find these foam rollers at your local Target or sports store, or just order one online.

In my experience, however, it is not just runners and bikers who suffer from a tight IT band. It seems whether you are quite sedentary or a very active person, the IT band tends to become tense. The foam roller is a good option, but there are also stretches that can give some relief as well. Pictured below are 2 stretches that I use and recommend to my clients.
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Make sure that you are really feeling the stretch on the outside of your thigh. It can be good to be in each stretch for 5 minutes or more, depending on how tight the IT band is.

And last but not least, of course massage is a huge benefit in relaxing the IT band. Several of my clients tell me that deep tissue bodywork is the only way that they feel relief in the IT band. Deep tissue is in fact very useful in lengthening the tissue. I usually will use what I like to call “The IT Sweep,” in which I have the client lie on their side. I then have them take the leg that is on top and flex it up and over the bottom leg, which exposes the hip of the leg on top. I proceed to take my elbow, and starting at the head of the femur, I “sweep” down the IT band all the way to the lateral side of the knee. This can be done 3-4 times to ensure the lengthening of that tissue. And honestly, it can be painful, just as the foam roller can be. But it works, and it works well.

After the IT sweep, I like to stretch the area. As mentioned before, it can be very difficult to stretch the IT band. But with assisted stretching from a licensed massage therapist or physical therapist, a deeper stretch can be achieved.

If you have concerns about your IT Band and want to hear more about treatment for it, please call me at 801-349-3934. I practice in downtown Salt Lake City, Utah and am always taking new clients. Call today to schedule your first appointment 🙂