Fallacies: IT band syndrome

Here we go again! The first few websites I read are totally wrong!!

A friend of mine just posted about having IT band syndrome. Having experienced this and know of the serious pain it causes, I was curious as to what the "experts" say you should do to treat it and what they say the causes are. Let me clear this up.

What NOT to do (that the experts say to do):

1. Take a Foam Roller directly to where you feel pain. NO, please Heavens NO!!! Connective tissue like the IT band is literally hard as a rock. For one thing, you are rolling in the wrong place. Secondly, rolling probably does more harm than good. But mostly it does nothing to the IT band.

2. Ice it. OMG NO!!! If you want to continue to feel pain and never let it heal, apply ice. The whole RICE fallacy has been disproved by the person who invented it. Ice slows the healing, just like it slows the movement of molasses through a tube. What do you do if you want to move molasses through a tube? Heat it up. Then it flows freely. All of your nourishing red blood cells and healing white blood cells are increased in circulation by heat. The rest of RICE is wrong too. Please don’t rest it. Instead, move it. And certainly don’t compress it. Its the friction across your bony surfaces that’s making your feel pain in the first place. Why do you want to create more friction by compressing it? Not very smart!

3. Stretch it. Haha, the experts are idiots!! First of all, a tendon stretches at maximum 3-5% of its length. The force that it takes to stretch a tendon is pretty extreme anyway. And why do you want to try to stretch a tendon in the first place? The tendon isn’t the problem. What does stretch are muscles. You see this standing, leg cross over, and lean to one side business that the experts describe and diagram? If your physical therapist tells you to do that, laugh over your shoulder while running away from him or her. You are not attacking the real problem.

OK, enough ridicule of the websites. Lets talk about something serious. Muscles contract and lengthen. Through a cascade of processes, muscles shorten (in the end) due to calcium deposited where actin and myosin fibrils unite. That’s what causes the contraction to take place. This in turn shortens the muscle. Potassium is an end product that aids the release of contraction. Sometimes, the brain will tell the body to dump calcium to shore up a structural issue and the muscle seizes either in a cramp, or a more semi-permanent contraction. The brain is saying "26.2 miles? Nope, I’m not doing it anymore. I’m going to stop this right now!!" This contraction essentially shortens the muscle. You can feel its effects when a whole bundle of muscles shorten and stay contracted. It is a taut fiber along the entire length. This taut fiber is continuously tugging on the tendons where they are attached. And that tugging of the tendon may causes downstream problems and pain.

So IT band syndrome is really taut fibers of muscle pulling excessively, probably in opposite directions creating pain just above the outer knee. Rolling, stretching, icing, or any other voodoo you do to an IT band does nothing. You have to deal with the taut fibers that are attached to either side of this upper tendon. And, as a matter of fact, the gluteus maximus, the largest and strongest muscle in our body attaches to the IT band. On the other side is another extremely strong muscle called the Tensor Fascia Latae (TFL). When one side goes bad, the other often does too. And both end up pulling on the IT band. Quit blaming the poor IT band and abusing it with a foam roller. Its not the IT band’s fault. Its the fault of those huge muscles at the top.

My best suggestion to you for IT band pain is to deal with the source of the problem. First of all, of you figure out how to palpate your own body, you can easily find taut fibers. Nearly all of us have taut fibers in our forearm muscles and in our neck. If you start to lightly find these fibers with your fingertips, you can figure out where the problem is. Go to the belly of the muscle, usually at the center or at the meatiest part, and don’t roll along its length (like you do with a foam roller). Instead, move across the fibers. Either roll your implement, like a lacrosse ball, massage stick, or a hardened metal bar across the fibers at the belly. Don’t be afraid to go hard at it. A gentle massage will do nothing to it. If you think about a powerlifter who squats 1,000 pounds, most of which comes from the gluteus maximus, those fibers are really dense and hard. You have to give a lot of pressure to open them up.

So what are my DO’s? Do the opposite of what the websites say:

1. MASSAGE BUTT & HIP FLEXORS. Get after the taut fibers of the gluteus maximus and the TFL. Massage really hard into those muscles. Maybe even use a TENS unit or electrical accupressure pen. That will allow those contracted trigger points to release so you can lengthen your muscles again. The release of the taut fibers means that it releases the pull on your IT band as well.

2. HEAT IT!! Yes, there is a reason we go to Hot Yoga and not Cold Yoga. Imagine that. You go to cold yoga and end up pulling and tearing every muscle in your body. That’s not a good scenario. You got to Hot Yoga to allow your body to lengthen more than it usually does. Heat is what you want, not cold. RICE is wrong!!

3. STRETCH IT! This also means, no Rest (part of RICE). Instead move and stretch the appropriate parts. Don’t stretch the IT band because it can hardly be stretched anyway. Instead, stretch the glutes and hip flexors. Pigeon pose, deep lunges, lizard pose: these all stretch the glutes. For the TFL, Warrior I (for the back leg), any bow pose (upward bow, bow [dhanurasana]), and any other pose that puts your hips into extension. Don’t rest or ice it. Instead, move it and heat it up. That’s what heals.

Lastly, because of the first few websites that popped up about IT band syndrome, always question what they say. For some reason, they all get this wrong. Learn to think for yourself. Our bodies are not magic. Well, they are, but that’s another blog post. We can figure out these problems for ourselves. All it takes is a little self-education and common sense.

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