Iliotibial Band Syndrome

Notice the iliotibial band is not a muscle

A common complaint that presents in my office is pain on the outside portion of the knee.  Some people refer to this as ITB or Iliotibial band syndrome.  It's very common with runners, crossfitters and fitness enthusiasts of all kinds.

So here's what happens.  Typically you are someone who does a very high amount of repetitive exercise.  Historically this has mostly been present with runners.  However lately I've been seeing it with crossfitters, particularly those who practice a very high volume of olympic lifts with dysfunctional technique.  

One thing that runners and crossfitters have in common is a limited amount of single leg strengthening activities. (Pistols being the only exception regarding crossfit).  When you don't utilize single leg strengthening exercises you tend to have limited abilities to stabilize the hip.

With that lack of stability at the hip, there is increased shear motion at the hip joint.  So in an attempt to control the movement, the Tensor Fascia Lata and Gluteus Medius muscles (smaller hip stabilizers) get overpowered and the stress is carried down through the iliotibial band all the way down to the attachment just below the outside of the knee.  So that attachment has to work hard to try to stabilize the knee AND hip and it just gets overburdened and inflamed and bam! You've got ITB syndrome.

It's really a pretty unique syndrome seeing that the iliotibial band is not a muscle, it's just a dense collection of connective tissue.  That's why people that have tried to massage or stretch the IT band end up frustrated because it doesn't work.

Two things to watch out for with ITB syndrome:

1) When the knee travels excessively toward the mid line of the body during any weight bearing movements.  This includes Olympic lifts, running, jumping, squatting, etc.  In the clinical world we call this a 'Valgus Collapse'.  The example picture is a gross example.  It's very common to see a much more subtle inward 'bounce' of the knee especially while returning to the standing position during something like deep squats or Olympic lifts.



2) Exercise Programming that lacks single leg exercises.  Examples of exercises would be lunges, pistols (single leg squat) single leg deadlifts, single leg jumps, etc.

Single Leg Deadlifts

If you have any questions or are in the Boca Raton area and would like to schedule an appointment please dial 561.997.8898 or email me at drscotthoar@gmail.com.  To check out more visit www.Mobility-4Life.com

How to Reduce the Stress on Your Body (Stability!)

Most people are aware of the concept of stability within their body.  However what I don't think a majority of us really know what stability is, and why you would want it.

Stability minimizes the amount of stress in your body.

Stability is not strength!  

Stability is a sequence of muscle groups firing in your body to maximize efficiency.

When you move your body in an ideal manner, there are segments of muscles that fire.  This is how is looks:

The inner core

1) INNER CORE - first the inner core fires.  This is the transverse abdominis, the multifidii, the pelvic floor as well as the diaphragm.  A bunch of small fancy worded muscles that should fire without you thinking about it.

2) OUTER CORE - the next wave is the outer core, which are the muscles people normally think of when they think of the core like; abs, obliques, lats, etc

3) Extremities/The Rest - The last thing to move should be things like the hips, the glutes, the shoulders, the biceps, etc.  

The problem is that after injuries or poor posture and lots of other reasons....our sequence gets thrown off.  Suddenly we start firing the 2nd or 3rd levels first.  When this happens you lose flexibility, compensate, maximize the stress on your body and open to door the pain and injury whether it's a sudden or gradual injury.  Studies show that people in chronic pain no longer have this sequence in tact.

The Outer Core

To evaluate if your stability is ideal I recommend you get evaluated by a sports medicine professional.  

The point of this article though it to point out that CORE STABILITY IS NOT HOW MANY CRUNCHES YOU CAN DO!  It's not the strength of the muscles around your mid section but rather if you turn the right muscles on at the right time so that you have ideal flexibility and minimize stress on your body.

How do you know if you have inefficient stability?  Can you touch your toes???  You probably don't if you can't.

For any questions or to schedule your own assessment please contact me at drscotthoar@gmail.com.   To check out more visit www.Mobility-4Life.com

Staying in Shape While Injured

Maintaining you physique and fitness levels while injured can be a tricky thing to do.  I always recommend substituting non-painful exercises for the ones you know bother you, or you just don't do so well.

Here's an article to check out regarding how exactly to do that.  http://www.backtothebox.com/how-do-i-fit-my-prehab-or-rehab-into-my-physical-performance-program-4/  

This is a bit 'Crossfit-oriented' but his template can be utilized in any exercise program you choose.  Happy reading!  

If you have any questions please contact me at drscotthoar@gmail.com.  To check out more visit www.Mobility-4Life.com