Rockin' With the IT Band

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Tuesday, October 3, 2006

Usually the phrase "irritated band" evokes images of gruff British rockers demanding more Ketel One backstage. For us (until our guitar skills improve), it refers to the iliotibial, or IT, band, a rope of fibrous tissue that extends from hip to knee, along the outside of the thigh. It can become cranky in us amateur fitness folk due to overuse or poor exercise form. The injury is most common in runners but also afflicts cyclists, swimmers, hikers and others who engage in repetitive, moderate-to-intense knee-flexing activities.

The IT band, which helps stabilize the body during ambulatory motion, hugs the lower knob of the femur. During non-excessive activity, the knee joint, drawing on a handy gel pack of lubricant called the bursa, keeps the IT band sliding silkily over bone.

But if you try to advance a training regimen too quickly or rush back from injury, the bursa can't produce enough lube and the IT band rubs coarsely over dry bone, says David Johnson, an orthopedic sports medicine specialist at the Washington Hospital Center. The irritation usually arises on the outside of the knee but can also occur at the hip, where the band attaches to that bone.

"I see this in runners and in people who go out and ride a bicycle 30 miles even though they haven't ridden in years," Johnson notes. He also treats a lot of 40-year-old guys. "They go out to play a sport and think they should [perform] like they did 15 years ago because they still feel the same physically." Ahem. Anyway.

An article in the journal The Physician and Sportsmedicine, from February 2000, noted that runners who stick to one side of the road often suffer the injury because most roadways peak in the middle and taper toward the sides, so every step with the curb-side foot forces tiny mechanical adjustments of which the IT band eventually disapproves.

The good news: You can prevent the syndrome -- and treat most cases -- with simple stretching and strengthening. People with weak hip flexor muscles are more prone to IT band pain.

For hip strength, lie on your side, prop head on hand and slowly lift one leg toward the ceiling. Use a light ankle weight if this seems too easy.

Also, per our standard tissue-protection rules, strengthen surrounding musculature -- gluteus, quads, hamstrings and calf muscles.

In addition, Johnson suggests these stretches:

· While standing, cross the ailing leg over the other one so feet are together, legs straight, and lean gently away from the hurt side, bracing on a wall for balance if needed.

· Place the ankle of the bad leg on the opposing knee and sit into a stretch, like you're doing a squat, keeping the bad knee out like a chicken bone. Do five, five-second reps of each -- until you feel the stretch, but not pain.

Even better news: In most cases you don't have to quit your activity, Johnson says. Cut your distance in half. If the pain doesn't recede, halve it again. Always ice for about 15 minutes after activity and take anti-inflammatories to treat pain. If pain persists for two to four weeks, see a doctor. And once you heal, return to action slowly and steadily.

Gotta run. The bloody Ketel One finally arrived. Questions about your IT band or other favorite body part? E-mail: move@washpost.com .

-- John Briley


© 2006 The Washington Post Company

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