For your information, let me reveal the first secret: The ITB is NOT a muscle. It is technically called a “fascia” which means a thick chord-like strand which has barely any or very little elasticity. The ITB primarily provides stability to the knee joint when the knee is in continuous action like walking, running, climbing etcetra. It runs in the outer part of the thigh from the hip to the knee.

But then, how can a structure, which has least elasticity create tension in the knee like other muscles which are far more elastic in nature??

The answer to it is though the ITB is not so elastic in nature, it is attached to elastic muscular structures at one end called the “Gluteus” muscle. Hence when the Glutei muscles are tight or weak they can exert tension in the ITB, which would result in a pain in the outer part of the knee.

 This irritability in the outer part of the knee is called as ‘Ilio Tibial Band Syndrome’ or ‘ITBS’. Common reasons for ITBS are:

• Lack of proper warm up before running and lack of stretching after running.
• Lack of proper strengthening exercises on a regular basis.
• Improper running forms like too much of in-toeing.
• Excessive hill training without proper rest periods for recovery.

Apart from the above mentioned reasons, rapid weight loss around the waist can also cause ITBS as the core and the body has to adapt to the body’s changes which impact how it bears weight.

Recovery

Recovering from ITBS is as difficult as many of us believe it to be. But it requires adequate stretches, strengthening and a bit of rest. As I have told you, the ITB is not a muscle, it’s a hard fascia structure which is less elastic. The muscles to which the ITB is attached are the Glutes and the Lateral Quadriceps. Hence to make the ITB more mobile and supple the adjoining muscles to which the ITB is attached has to be made more flexible and strong.

Ensure your natural knee brace stays “BRACED” always.

Below are a series of stretches and strengthening exercises to treat and prevent ITBS

This is a glute and a deep hip stretch. You need to lie on your back and pull the knee towards the centre of your chest and hold it firm there while you pull your foot towards the floor using the other hand. You need to hold it there for 20 seconds and repeat it three times. It eases the proximal attachment of the ITB.

This is a direct ITB stretch. You need to sit on a firm surface with one ankle on the other knee. Then gently press the knee down and bent towards the ankle. Hold this position for 20 seconds and repeat three times on each side.

This is a strong quadriceps stretch. You need to kneel on a cushioned surface and place the other foot on the ground firmly. Then fold the foot towards the butt. Hold this position for 20 seconds and you may repeat it 3 times on each side. Ensure that the knee cushioning is adequate for comfort.

This is an inner thigh stretch. This needs to be done in combination with the other stretches to ease out the tension in the ITB. You need to sit against a wall with your back well supported and feet against each other. Then gently press the knees down towards the floor and hold it for 20 seconds and repeat it 3 times.

The free squats are a basic form of strengthening the quadriceps and the glute muscles. Amateurs may do these without weights and elite exercisers may do them with a pair of dumbbells or barbells. You may do it in 3 sets with repetitions of 18,15,12 in consecutive sets for good strength gains.

The elevated back foot lunges are amazing for strength gains in the glute and quadriceps muscles. They are tougher than squats. Again for amateurs, you may do it without weights by placing the back foot on an elevated platform and lunging by bending both the knees simultaneously. For greater strength gains you may do 3 sets of them with repetitions of 18, 15, 12.