Are you tapering for the Melbourne Marathon this weekend, but worried about persistent ITB or pain at your lateral knee?
ITB syndrome or friction syndrome wan be caused by overload and tightening of the ITB from repetitive use of the TFL and quads, such as in long distance running or cycling.
One of the primary causes of ITB Syndrome is the overload and tightening of the iliotibial band due to repetitive activities. These actions often involve the hip and knee repeatedly flexing and extending, which can irritate the tissue. The following factors commonly contribute to the development of this condition:
- Overuse and Repetitive Motion: Activities like long-distance running, cycling, and hiking put consistent strain on the ITB, leading to increased friction over time. In these sports, the band repetitively rubs against the lateral femoral epicondyle, a bony part of the knee, causing irritation.
- Tightness in the Iliotibial Band (ITB): A tight iliotibial band can reduce flexibility and make the area more prone to friction. This tightness often develops from insufficient stretching or muscle imbalances.
- Tightness in the Tensor Fascia Latae (TFL) and Quadriceps: The TFL (Tensor Fascia Latae), a muscle on the outer side of the hip that helps stabilize the pelvis during movement, plays a key role in the functioning of the ITB. Excessive use or tightness of the TFL, often seen in activities like running or cycling, can pull on the ITB and contribute to its dysfunction. Similarly, tight quadriceps muscles (front thigh muscles) can also increase tension in the ITB, exacerbating the friction.
- Biomechanical Imbalances: Poor running or cycling form, such as overpronation (excessive inward rolling of the foot) or weak hip stabilizers, can contribute to excessive stress on the ITB. These imbalances lead to improper alignment and overloading of the iliotibial band, increasing the risk of irritation.
- Inadequate Warm-up or Stretching: Failure to properly warm up or stretch the muscles around the hip, thigh, and knee can make the ITB more vulnerable to injury. Stretching and strengthening the muscles that support the ITB, including the TFL, glutes, and quads, is essential to maintaining proper function.
A good tip at this late stage in your training schedule, is to utilize ‘activating’ your glutes before the race.
Glute Activation Before Running
One effective way to prevent or reduce Iliotibial Band (ITB) Friction Syndrome, especially in runners, is by properly activating and strengthening the gluteal muscles before running. The gluteal muscles, particularly the gluteus medius and gluteus maximus, play a crucial role in stabilizing the pelvis and controlling the movement of the hips and legs during physical activities. When these muscles are weak or not sufficiently activated, the Tensor Fascia Latae (TFL) and quadriceps tend to take over, increasing the tension on the ITB and contributing to friction.
Why Glute Activation is Important
- Pelvic Stabilization: The gluteal muscles, especially the gluteus medius, help stabilize the pelvis during running. If the glutes are underactive, the pelvis may tilt or wobble excessively, which can lead to improper knee alignment and increase strain on the ITB.
- Reducing Overuse of the TFL and Quads: Properly engaging the glutes helps to balance the load and reduce overreliance on the TFL and quadriceps. When the TFL is overworked, it pulls on the ITB, leading to increased friction and potential inflammation.
- Better Hip and Knee Alignment: Activated glutes promote better alignment and control of the hip and knee joints, ensuring a more balanced and efficient running stride, which decreases the likelihood of ITB irritation.
Glute Activation Exercises Before Running
To reduce the risk of ITB Friction Syndrome, it’s helpful to include some simple glute activation exercises in your pre-run routine. These exercises warm up the muscles and ensure they are firing correctly during your run.
- Glute Bridges:
- Lie on your back with your knees bent and feet flat on the ground.
- Lift your hips towards the ceiling, squeezing your glutes at the top.
- Hold for a second and lower back down. Repeat 10-15 times.
· 2.Side-Lying Leg Lifts:
- Lie on your side with legs extended and stacked.
- Lift the top leg toward the ceiling while keeping the hips aligned.
- Slowly lower it back down and repeat 10-15 times on each side to engage the gluteus medius.
·3. Crab Walks (with resistance band):
- Place a resistance band around your thighs just above your knees.
- With a slight bend in your knees, step sideways, keeping tension in the band.
- Take 10 steps to the right, then 10 steps to the left, ensuring the glutes are fully engaged.
4. Walking lunges or static deep lunges
– in a long stride stand with rear heel lifted
– bend both knees like to create a down and up lunge movement (not forwards and backwards
– repeat x 20 each leg, for one or 2 sets if possible
Fire up those glutes to prepare for the half marathon or full marathon, and don’t forget your physiotherapist can help with ITB syndrome before and after the run!
