Updated: Dec 17, 2021
Ever get a nagging pain on the outside of your knee, maybe after a walk, run, or cycling session?
Through the years we all believed that this pain was originating from a thick band of fascia that runs down the lateral side of your leg, you may know it as the Iliotibial Band (IT band).
It was first thought that this pain was created by the back and forth motion of the IT band over a bony landmark on your knee called the lateral epicondyle. This back and forth motion was thought to create a type of friction due to overuse and consistent rubbing, which we named the Iliotibial band syndrome (ITBS). However, over the years we have discovered a few new things regarding the IT band and how it functions!
The IT band does not move back and forth, it is actually attached to both bone and muscle keeping it in place during movement.
The IT band starts at the crest of the iliac then inserts in different areas within the femur and the tibia, due to these deep insertions the IT band cannot technically glide over the lateral epicondyle but instead created an illusion of movement by stretching.
Similar to the Achilles Tendon, the IT band is now thought to be an elastic structure that helps save and recycle energy for easier movement. As the leg swings backwards, it saves the energy to then be used for the forward swing of the leg, making walking and other movement more efficient and easier for us to accomplish.
The IT band and lateral epicondyle are separated by a fat pad that could be a possible cause of pain if inflamed and pressing against the IT band. This pad can become irritated over time by excessive inward rotation of the thigh if there is an imbalance between the abductor muscles and adductor muscles. The IT band not only helps with stabilization and abduction of the hip, but also aids in the extension and flexion of the knee.
Though we are still learning a lot about the IT band and the best way to release tension within it, we do know now that the IT band is deeply connected with different muscles such as the Tensor Fasciae Latae (TFL), Gluteus Minimus, and Gluteus Medius; we also know that it lays near both your Bicep Femoris (hamstring) and Vastus Lateralis (quad muscle) as well. These other muscles could very well be an underlying reason for any tightness or pain you may be experiencing in the knee area.
So remember our on-going principle: when one muscle is affected it tends to have a trickle down effect to other parts of the body. And when trying to resolve the issue of knee pain, it is beneficial to start with these other areas before focusing on just the IT band itself!
Follow a few of the stretches below and see if that nagging outer knee pain reduces!
Stay strong and healthy my friends!