Is it normal to have a tight IT band?

Everyone has a tight IT band, right?

Anyone who has had massage or soft tissue work done on a tight IT band will know exactly how tight and tender this area can get. It really is quite horrible.

For those of you that haven't heard of the IT band before it is simply a piece of connective tissue that runs down the outside of the thigh. The IT band is short for the iliotibial band (sometimes also known as the iliotibial tract). Along with a muscle called call the tensor fascia lata the IT band helps stabilise the knee, from the outside, in weight bearing activities such as running and hiking.

A tight IT band can cause a number of problems such as anterior knee pain and IT band syndrome. It can get tight for a number reasons, however poor bio-mechanics in walking and running as demonstrated in the video in this blog post are most often related to increased tension in the IT band.

The two major tests that we use in the clinic to assess the tension in the IT band are:

Obers test

Thomas test 

In a significant number of cases we will find these tests show 'positive' results, indicating that the IT band is overly tight. There are many reasons for this including poor bio-mechanics as mentioned above. However, one aspect that must not be missed is that many people simply put their body under huge load without taking the appropriate measures to offset this load. High training volume, with poor postural patterns (e.g. poor sitting position at work), can lead to imbalances, increased tension and specific weaknesses in the tissue. If your training volume is high, and you are not carrying out regular basic maintenance on yourself, then it is very likely you will end up with a tight IT band and consequently injuries can occur.

So, back to the original question, 'Is it normal to have a tight IT band?' My answer, NO, it is not normal however it IS very common. For this reason it is hugely important to carry out regular self maintenance e.g. Foam rolling, mobilising, self trigger point work, stretching, glute and core strengthening exercises, balance and proprioceptive work as well as regular massage will all help reduce your chances of developing a tight IT band. 

My National 3 Peaks Challenge Story

(Picture: Piper - The Highlands)

The 3 tallest mountains in the UK.

21 hours 50 minutes, 57214 steps, 25 miles and 11170 feet.

The three peaks challenge completed!

To those of you who haven't come across the

National 3 Peaks Challenge the aim is to climb Ben Nevis (Scotland), Scafell Pike (England) and Snowdon (Wales) in 24 hrs - including driving time.

This is a short post on how Matt (who talked me into doing the challenge) and I got on completing the 3 Peaks.

We started in Scotland at Ben Nevis on Friday 17th June and finished in Wales at Snowdon 21h50 later.

BEN NEVIS - The Start

(Picture: The Start - Ben Nevis visitor centre car park)

(Picture: Summit Ben Nevis)

Summit time: 2h05

Total time: 3h24

Height: 4409 ft

Steps (Pedometer): 21858

We were planning to start the challenge at 7pm (Friday), with the aim of getting up and down the Mountain before dark at around 10.30pm. However due to poor weather and less evening light we changed our plans and started early at 6.40pm.

The climb was in fairly poor weather; rain and cold, with thick cloud at the top. This made things fairly hard going, visibility at the top was down to about 15 feet.

We could easily see how people get in trouble on Ben Nevis, the cloud cover was fairly disorientating.

We managed to get up and down in fairly good time (3h24), with much of the descent done

running. By the time we reached the bottom I wasn't sure if we had gone off too fast and should have left 'more in the tank' for the next two mountains.

On getting down we managed to leave the Ben Nevis visitor centre car park fairly quickly. We got in the car for a 6 hour journey down to Scafell Pike (Lake district). At this point Matt and I did our best to get some sleep as we were being driven by my Mum and Gemma (my girlfriend).

SCAFELL PIKE

(Pictures: Top of Scafell Pike)

Summit time: ???

Total time: 3h58

Height: 3210 ft

Steps (Pedometer): 20356

After traveling to Scafell Pike overnight we arrived at about 4am. We were not sure how our legs were going to be functioning after 6 hours sitting still in the car. As it turns out the legs were actually OK, however this was the least of our worries.

After quickly getting out of the car at just after 4am we headed off on what we thought was the right track. We quickly caught up with 4 other walkers doing the 3 Peaks and checked with them that we were on the correct route. They confidently said "yes" so we got our heads down and got cracking - big mistake. To cut a long story short we had headed off on the wrong track. We had been 'at it' for 40 minutes before we realised that we had gone the wrong way! What was more soul destroying was that we realised that the quickest way to get back on track was to run right back to the start and begin again, there was no other obvious 'short cut' to get back on the correct trail from where we were.

By the time we had reached the bottom again we had wasted exactly 58 minutes, but more importantly we had sapped valuable energy out of our legs. Disaster. There was no other choice but to get started again. Although Scafell Pike is the smallest mountain in terms of height it seemed to be the toughest of the three mountains. There is a boulder field about mid way up and the top section is covered in scree which makes things hard work.

As with Ben Nevis the weather was poor so we reached the top in almost zero visibility and ice cold driving rain. We made a quick stop to take the photos and headed back down. Due to our mistake at the start we took almost 4 hrs on a mountain we were planning to complete in under 3 hrs. In low spirits we quickly got changed into dry gear and got in the car for the 5 hour journey to Snowdon.

SNOWDON

(Picture: Snowdon - at the peak)

Summit time: 1h35

Total time: 2h56

Height: 3560 ft

Steps (Pedometer): 1500 - approx

Although we wasted an hour on Scafell Pike we were still on to complete the challenge in the allotted 24 hrs - all was left to play for.

Our aim was to finish strong. That meant we had to complete Snowdon in under 3 hours. We knew it was going to be painful.

For the first time we set off without any rain, which was a great change.

We were most confident about completing Snowdon as it was the only mountain we had climbed prior to the challenge. In fact we had climbed it twice in one day while we were doing our training.

We managed a very fast time to the top, by our standards, making the peak in 1h35. The top was packed with other walkers so we quickly got our photos and began back down. By this time our legs were like jelly and are knees were sore but we had to get down quickly to make sure we made it in under 3 hours.

After what seem like an age we rounded the final corner, the visitor centre car park was in sight. We knew we were going to complete Snowdon in under 3 hrs! With 4 minutes to spare we jogged into the car park and had completed the National 3 Peaks Challenge in a total of 21h50.

Tired, beaten up but very proud we had managed to do all three of the highest mountains in the UK under 24 hours.

A great achievement.

21 hours 50 minutes, 57214 steps, 25 miles and 11170 feet.

Knee Pain? Grinding, clicking or clunking

Increasingly more and more people have been coming to see me at the clinic with Patellofemoral Pain Syndrome (or pain at the front of the knee).

The pain is often associated with grinding, clicking and clunking in the knee which is made worse by squating type movements and walking up/downstairs.

This grinding, clicking and clunking is NOT normal and will most likely indicate that your patella (or knee cap) is tracking poorly. If your patella is not tracking correctly at the front of the knee then it will 'rub' against the edge of the femur, which will in turn cause it to grind, click or clunk.

Alongside the grinding, clicking and clunking some people also report a 'giving way' in the knee or a general feeling of being unstable.

Again this is NOT normal.

The good news is that with the correct treatment this pain (as well as the associated grinding, click and clunking) can normally be resolved successful with out the need for any surgical intervention.

The cause of this 'poor tracking' in the knee is often due to muscle imbalances in the thigh muscles (quadriceps) and weakness in the hip muscles.

With the correct exercises and treatment most often these imbalances can be addressed.

For a more detailed explanation of Patellofemoral Pain Syndrome click here.

Additionally if you have any questions you would like answered about you own knee pain please do email me.

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Treatments that I use to resolve Patellofemoral Pain Syndrome, may include some / all of the following:

1. Mobilisations to the patella to 'free up' tight structures.
2. Massage to the IT-Band, to help address the muscle imbalances.
3. Home exercises specifically designed to even out the muscle imbalances.
4. Ultrasound to help improve the inflammatory process.
5. Taping to help re-position the knee cap.
6. Referral to a podiatrist if your imbalances are associated with poor bio-mechanics at your feet.