The Myth of IT Band Pain

The final episode of "MythBusters" aired this past weekend.  I don't know about you, but I'm going to miss their epic goatees, pursuit of science, and blowing things up for pure enjoyment.

This week I'd like to pay homage by putting on my own science cap, requisite goatee, and busting one of the strength and conditioning world's myths.  The problem is that there are a ton:

  • Lactic acid isn't what makes your muscles burn, it's an excess of hydrogen ions from the Krebs cycle.  
  • Sit-ups and crunches aren't going to give you a six pack, they may actually hurt your lower back.  
  • Heavy weights won't make you bulky, but overeating might.

All three of those truths aren't just #broscience but actual science.  Yet I'd like to focus on one particular problem commonly seen in runners: IT Band pain.

I never doubt when people are in pain, but for a tiny piece of fascia on your outer thigh, it sure is the target of a lot of frustration.  What if I told you that the pain in your IT band wasn't actually your IT band?  Rather, it's the result of a badly positioned pelvis.

If you've foam rolled your IT band repeatedly, you know it may feel better in the short term.  But scratching a mosquito bite will make that feel better too.  Are either long term solutions?  I think not.  Alas, if foam rolling your IT band hasn't cured the problem yet, it won't.

To solve the problem, we need to go deeper than foam rolling.  But if all you care about is feeling better, I encourage you to skip ahead to the "How to Fix It" portion below.

Myth Busting 101: The IT Band is Not Your Enemy

 Ober's Test - Just like episodes of The Bachelor, there's more than meets the eye.

Ober's Test - Just like episodes of The Bachelor, there's more than meets the eye.

In the world of testing and assessments the Ober's Test has historically tested for "tight" IT bands.  But as our understanding of anatomy has grown, we've realized that this test isn't really testing our IT bands.  Instead, it's a test for the position of our pelvis.  If we pass it, it'll *look* like we have a normal length IT band.  If we don't?  It'll look like we're tight, but that's only because we're living life in extension with dat bootay.  

Further proof came from this study, illustrating that the IT band cannot be stretched.  Researchers took 20 embalmed cadavers and tried three different IT band stretching techniques.  And even though The Walking Dead and Fear the Walking Dead have biased me towards a serious distrust of cadavers, the results spoke volumes - the IT bands didn't stretch.

If we know that the position of our hips influences the traditional IT band test, and that our IT bands can't be stretched, how do you fix the problem?  And why does the IT band area hurt if that's not the problem?

How to Fix it? 

We commonly blame the IT band, but it's actually our vastus lateralis desperately trying to hold us up.  If our pelvis is in the wrong position, there's a sequence of events that encourages our brain to use our thighs and hip flexors to stabilize our pelvis - a job ideally reserved for our obliques and hamstrings.  It only makes sense then that our plan of attack should focus on the latter two muscles.

In order to get our obliques firing we need to learn how to exhale.  The most effective way to do that is to bring ourselves down to our hands and knees, and focus on getting all of our air out and feeling our abs.

The greatest challenge in this breathing drill is getting all of your air out.  It's easy to get out the first 80%, but the last 20% is what really makes it the most effective tool.

Once we've exhaled and have our abs back, we need to make sure we can keep it while we're moving.  I'm a big fan of using dead bugs to challenge your this breath and stability, as it simulates movement. 

Lastly, we need hamstrings and we need to get out of extension.  The cure?  As always, deadlifts.

When we can activate our abs and turn on our hamstrings, we're going to bring our pelvis back to a neutral position.  Once we're neutral, our IT band pain will subside as we'll have the right muscles holding us up.

Of course, that's all easier said than done because we're not just training the body, we're really training the brain.