While most people have probably never heard of it, the iliotibial band (or IT band) is one of the most important and hardworking parts of the body. The IT band is a thick band of fibers which extends down the outside of the thigh to the shin, helping to stabilize the knee and aid movement.
Many athletes, especially runners, regularly exert a lot of pressure on the iliotibial band, and it can easily become tight or inflamed, causing severe discomfort and pain in the area. This is commonly known as iliotibial band syndrome (ITBS), and is a common overuse injury seen by sports massage therapists. Fortunately, there are a number of massage techniques that can prove beneficial to ITBS sufferers and help to aid in their recovery.
The iliotibial band begins at the iliac crest bone in the pelvis, and extends down to the lateral side of the thigh, attaching to the tibia. The tensor fasciae latae (TFL) muscle in the thigh attaches to it, which assists with flexing and rotating the hip.
The gluteal or buttock muscle fibers are also connected to the IT band, including the gluteus medius, which stabilizes the pelvis and femur when running or jumping. Students in sports massage therapy courses learn that 80% of the gluteus maximus, the largest muscle in the body, is inserted in the IT band, further underscoring the amount of pressure it can come under.
With so many connecting muscles, the root causes of iliotibial band pain can vary. Weakness of the inner hip muscles may cause the tensor fascia latae (TFL) muscle to overcompensate, in turn placing increased tension on the iliotibial band.
Weakness in the gluteus medius can also be a factor, as it may cause movement dysfunctions in the femur and pelvis, and place increased pressure on the iliotibial band to stabilize the thigh. Other external factors can also place stress on the IT band, such as running uphill or on uneven surfaces, or simply overtraining.
In massage therapy college, students develop precise assessment skills and learn a number of modalities which can be useful in treating ITBS sufferers. The treatment is based on the assessment and a determination of underlying causes. For example, if a therapist detects tightness in the TFL, they may apply myosfascial release therapy to the afflicted area, stretching and loosening the fascia around the muscle to allow it to move more freely, which can often release some of the pressure on the IT band.
In the case of muscle imbalance, active therapies such as muscle energy technique and therapeutic exercise may be utilized to help restore range of motion and strength in the muscles so that they can perform as they should, relieving the load on the IT band.
An RMT may also choose to perform more conventional post-injury sports massage on an ITBS sufferer, to release tension in the muscles and fascia around the area and stimulate blood flow.
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