Iliotibial Band Problems = Knee Problems


What Is The Iliotibial Band?

The Iliotibial Band (IT Band) is a long stretch of tendon that runs from up high in your hip all the way down to the outside of your knee and attaches onto the tibia.  The IT band is responsible for stabilizing the outside of the knee when running or jumping.  This thick chunk of tendon can withstand up to 1000 lbs of force.  In fact, if you can get your hands underneath it, you can actually lift up somebody’s entire body.

The IT band also works with the muscles of the quads and hamstrings.  The outermost regions of these muscles, when contracted, push against the it band.  This causes the it band to tense up and provide an even greater level of stabilization than before.  Adding to this stabilization is the lateral collateral ligament (LCL).  Out of all the ligaments of the knee, the LCL is by far the strongest.  The LCL is on the outer portion of the knee underneath the IT band. 

It goes without saying that the IT band has a pretty strong influence on the stability of the outer leg.  But this stability can also be a bad thing when it is not functioning properly.  For many people, the words Iliotibial Band makes them cringe. 


How Does The Iliotibial Band Actually Work?

The Iliotibial Band should only work in one way, the way it is SUPPOSED to work.  Often times you hear that the infamous IT band syndrome is caused by weak gluteus medius.  Now there is some truth to this, but there is still one big piece of information being left out.  Let me spill the beans in three words: Tensor Fascia Latte (TFL).  Yes that’s right!  This tiny little muscle that is way up in the front outer region of the hip actually causes most of the problems of IT band syndrome. 

The gluteus medius does need to be strong in order for the IT band to work properly.  But it also has to fire at the right time in order for the IT band to work properly.  Abduction requires the contraction of three muscle groups, the gluteus medius, the TFL and the quadratus lumborum.  The gluteus medius is supposed to fire first, then the TFL and finally the quadratus lumborum.  If the gluteus medius is weak, or doesn’t fire correctly, then the TFL and quadratus lumborum become tightened. 

The TFL in particular is the worst part of this.  The TFL is the muscle tissue that is actually attached to the top of the IT band.  Tightening this muscle group will lead to the tightening of the IT band itself.  The IT band is just a long stretch of tendon.  When the muscles that attach to it tighten, the entire sheath itself will also tighten.  Until there is some kind of fascial release of the TFL, the entire IT band will continue to become tight and cause problems. 


Fixing The Outer Leg


TFL Release

Let me start by saying this, rolling the Iliotibial Band will do absolutely nothing to fix the outer leg.  The tendon sheath is just way too strong.  Foam rolling wont even make a dent in that thing.  The way to target the IT band is by first working upstream in the hip.  The first area of business is to release and calm down the TFL. 

You can find the TFL by sticking your hands in your pockets.  The pockets on most pairs of jeans and shorts are conveniently placed right on the TFL.  To re-confirm this, place the tips of your fingers in your pockets and then move your leg away from your body.  The little bulge you feel is the TFL.  This is our target area. 

Place a tennis ball, lacrosse ball or yoga tune up ball in this area and smash the hell out of it.  If the TFL is really tight, I will spend up to five minutes on each side.  Since we are also in the area, we might as well roll out the glutes too.  The glutes get solidified and inactive with too much sitting and need a jumpstart to get working again.  You can spend a good amount of time here as well (5-10 min).  In the future when these areas aren’t so bad, you can significantly reduce the amount of time you spend mobilizing these areas. 


Fire Up The Glutes

The TFL has been released and you have rolled out the glutes.  The next step is to reconnect the nervous system to fire the glutes.  The glutes are a tricky pair of muscles because they are mainly phasic.  This means that if you are not actively using them in your movement patterns, they will just turn off. 

To reactivate the glutes you first need to do glute activation drills everyday for about 1-2 weeks.  This includes simple exercises such as:

  • Prone Straight Leg Kickbacks
  • Jane Fonda Side Lying Leg Raises
  • Clamshells
  • Cook Hip Lifts

Once the glutes feel tense, and in some cases sore, the next step is to learn how to properly activate them during compound movements.


Wall Squats

This is a very effective exercise for teaching basic squat mechanics.  Stand facing a wall and place your feet about 4-6 inches away from the wall.  Keep your toes facing forward the whole time and squat down to the floor without touching the wall.  You will find that this is much harder than it looks. 

Wall squats will teach your body to open up your hips and will fire your glutes.  Most new trainees that perform this exercise often tell me how sore their glutes are after they do this exercise.  For the best results aim for anywhere from 50-100 reps per day. 


Goblet Squats

Goblet squats are great in that they are so simple to teach and perform.  Simply grab a dumbbell hold it against your chest and squat all the way down to the floor.  Some trainers like to tell people to point their toes outward.  I disagree with them.  I find that when the toes are pointed outward people are more likely to cheat.  Instead, point your toes forward.  This will ensure that you cannot cheat without it being obvious.  Squatting with the toes forward will also draw out any hidden mobility issues.   

Perform 5 sets of 10-12 reps with a moderately heavy dumbbell.  Don’t go too heavy, were not trying to flex our testosterone, we are just trying to work on our form.  Every rep in which our glutes don’t fire is a missed rep.                     

2 thoughts on “Iliotibial Band Problems = Knee Problems

  1. g says:

    You can definitely see your enthusiasm within the
    article you write. The world hopes for more passionate writers like you who are not
    afraid to mention how they believe. At all times go after your heart.

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