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Runners: ITB Syndrome and the “Stiff” Pelvis

If you are an avid distance runner, you may experience a tight and painful sensation on the outside of your thigh, termed ITB Syndrome (ITBS). The Illiotibial Band (IT Band) is the combined tendon of the Tensor Fascia Lata (TFL) and the Gluteus Maximus (GM) muscles. The TFL and GM muscles are hip joint mobilizers and their tendon, the IT Band, extends down to the lateral side of the thigh, attaching just below the knee joint. As the contraction of the Tensor Fascia Lata (TFL) and Gluteus Maximus (GM) muscles affects the tension of the IT Band, it can become tight and painful with extensive hip activities like running. The emphasis on big and powerful strides may also inadvertently “stiffen” their pelvis with excessive TFL and GM muscles contractions, resulting in a progressive tightening of the IT Band.

The conventional way of addressing ITB Syndrome is to stretch the IT Band with deep massage and/or rolling over a semi-rigid foam log. These method do yield some increase in tissue flexibility but the effects are generally temporary. To use an analogy, this approach is akin to attempting to stretch a guitar string by rubbing and rolling it with a rod! Therefore similar to a guitar string the implication is that by loosening the string tuning knobs at the headstock of the guitar, the string will slacken. In regards to a free and mobile pelvis, preventing excessive contraction of the TFL and GM muscles will prevent the IT Band from becoming excessively tight.

How would you allow movement of the pelvis when running? First of all, the pelvis has to be positioned at a neutral angle (with natural lumbar lordosis, “the neutral spine position” to engage the spinal core muscles) and allowed to rotate around a vertical axis. In other words, the pelvis moves forward and backwards in integration with the legs, i.e. during the swing phase of the stepping leg, the pelvis naturally rotates backwards to allow hip joint clearance for the flexing hip, and upon foot strike the pelvis rotates forward to assist with the push off/propulsion phase. This more natural way of running promotes maximal efficiency of the TFL and GM muscles, preventing ITB tightness and associated conditions. Furthermore, it makes running a less strenuous and a more enjoyable experience!

Recap:

Maintain good posture with a natural curve of your low back, take small steps via lifting a bent knee (like running in place), allow pelvis on the same side to rotate back. Land with foot directly under body (on the mid or forefoot), pelvis rotating forward as you push off without pushing down on your foot (minimizing excessive calf muscle contractions) during the propulsion phase, repeat. To go faster, lean forward from the ankle (to allow “falling forward” momentum) to induce a spontaneous increase in your movement cadence.

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