What is ITB Syndrome “Hip Bursitits”
As your racing schedule heats up many of you will arrive in my office with “hip pain.” What most people don’t know if that pain coming from your actual “hip joint” shows up in your groin. The pain most runners attribute to their hip is acutally right over the outside of the femur bone and traveling down your leg.
You know this as either bursitis or IT Band syndrome but did you know you develop ITB (iliotibial band) Syndrome because your butt is too weak to support your pelvis?! During each step your body tries to stabilize the pelvis by tightening the muscle at the top of the IT Band, the tenser fascia lata, and tightens the ITBand itself. This tightness can inflame the bursa (soft tissue sac) underneath the ITBand and actually effect both your stride and the fluid motion of your knee.
We can prevent and fix ITB syndrome with 2 easy solutions: increasing Butt strength and Foam rolling your IT band.
Build a better Butt:
My favorite exercise for maximizing butt strength is called the monster walk and focuses on the all important gluteus medius. You will feel the burn just behind the lateral hip (greater trochanter).
Place a continuous exercise band around your ankles. Begin with your feet facing forwards and shoulder width apart. Bend your hips and knees into a short arc squat and stick your butt out. Now step to the right with the right foot and then to the right with the left foot. Always keep tension on the band. Repeat with10 steps to the right and then repeat to the left. Perform 2 sets.
Other great Butt builders are found in this video:
“A weak Butt kills the runner.”
Stretch the IT band:
There are many stretches out there for the IT band but the only truly effective method I have found for lengthening this tight fascial tissue is foam rolling! This is like giving yourself a deep tissue massage and will break up all the micro-scar tissue that keeps your IT band tight.
Lay with the side of your hip directly on the foam roller. Using your upper body slowly pull your leg back and forth over the roller from your hip to your knee and back.
Let me warn you…this may initially hurt but it will hurt so good as it stretches out the stubborn ITB and increasing blood flow to the area.
You should foam roll problem areas daily before your workout.
Here is a video demonstrating foam rolling of the ITB
Stretch your Butt:
50 % of your Gluteus muscle inserts directly into the ITB. If your butt is tight it will pull on your ITB and increase the friction. Prior to running you can use your foam roller to loosen up your butt. After your run spend 30 seconds stretching each gluteus medius with the pictured stretch either standing or laying on your back.
Ice massage:
When you finish a run and your post workout stretching, make sure you take to ice your hot spots. I recommend my runners use ice “massage” instead of simply slapping a bag of ice on. To do this, freeze Dixie cups of water ahead of time, peel back the paper and rub/massage the ice over your IT band for 20-30 minutes. This minimizes inflammation and speeds healing by increasing circulation.
Anti-inflammation:
Hot spots, sore joints and ITB syndrome are not simply painful but centers for inflammation and the chemical defenses your body uses to protect and heal your tissues. Too much inflammation is not great. You can cool those hot spots and minimize the pain that comes with by using natural (omega 3 fish oil, tart cherry juice) or over the counter (advil, aleve) anti-inflammatories.
Follow these simple prevention and treatment tips and you are going to eliminate IT band syndrome and bursitits.
I have been unable to find a doctor to help me with IT irritation since having a hip replacement 7 years ago at the age of 51. The pain seems to be near the greater trochanter. It gets very severe from time to time. It is very unpredictable. This morning I could hardly walk. The stretching exercises did not work. I am an engineer, not a doctor; however, your discussion of the problem made me curious about what might apply to a putterer like me rather than a young athlete. I cannot always wear a ice pack and cannot stop what I am doing all the time to prevent it from worsening. It is already bad.
i don’t understand your instructions for strengthening butt. please tell me,
what is a short arc squat?
Thank you for this article. It reassures me that my Physical Therapist is in tune with what needs to be done to relieve this hip pain, which is absolutely horrible.
Having chronic pain anyway, this has been my last straw. Many hours of crying!
Thank you.
Hi.
I am confused about the right way to deal with IT Band inflamation. I enjoyed the article above and have seen other articles discussing Foam rolling the IT Band. However I have also come across some articles saying that directly foam rolling the IT Band is not a good idea and that a better approach is the foam roll the muscle groups surrounding the IT Band (thigh muscles, hamgstrings and gluts).
I know most people need to try different things and see what works best for them individually. However I was curious if you could comment on the differing views on Foam rolling various areas related to the IT Band.
Thank you!
Richard.
I just saw an orthopaedic surgeon for my cox arthrosis and IT band syndrome and his opinion is that rolling IT bands is completely useless. To explain he told me to see IT band as a cord. Foam Rolling a cord is useless. He suggested to stretch the glutes and muscles like you just said.
In his opinion I need IT band release surgery as this has become a chronic problem for me.
I think you will find your PT knows more about how to deal with overuse injuries and problems like bursitis than your ortho doctor. Some ortho doctor’s are so dismissive if you aren’t an athlete.
I had chronic bursitis a couple years back. I was very active then, doing a lot of cycling. Cortisone shot after cortisone shot didn’t help — what finally did was a technique called ASTYM which was done at the PT office and then working with them to build strength and say stretched. Sometimes bursitis is aggravated when your quad muscle is stronger and your hamstrings are tight.
Pain pills and cortisone shots are temporary and will stop working even briefly after a time. Get with a good PT. And put in the time… will need 2-3 visits a week for a while.
It will be worth it.
Wonderful advice. Thank you. Going to start tonight!
A great article , thank you
My IT band feels like it is stuck over the back of my hip bone and it won’t release. Any advice? The pulling on this band causes a pelvic tilt and extreme pain from my neck to my heels.
I’ve read your article on ITB syndrome,and believe that is my problem.I have
tightness in my left hip and glute.I do a lot of intense cycling with many difficult
hill climbs.Your article states that ITB can cause knee instability.My IT band is
getting stuck for a brief moment as it slides over the bursa on the outside of my
knee causing me to fall.It happens very sporadically.I am using a cane so I can
maintain my balance when it happens.This happened to me last July about a half
dozen times then cleared up until recently.When it happens if I catch it and flex my knee it’s gone,and I’m fine until the next time.I don’t have any knee pain when
cycling,swimming or with any of my strength training for my lower body.I just want your expert opinion on this issue.Thank you.