ITB SYNDROME, IS IT A PROBLEM?
When I say at Pose Tech running clinics that my students do not have this problem, I usually get something like: "Yeah, yeah, yeah, keep talking". It is really difficult to get people to accept the fact that this is not fatal - to run and to not have any negative consequences.
As I see on our website's Running Forum, ITB syndrome is a hot topic, which means that lots of runners went and may still be going through this unpleasant experience. And I really want to help these people who were deprived of running.
As probably most of the readers know, the ITB syndrome is related with lots of painful symptoms in the area called iliotibial tract consisting of muscles and fascia tissues running down from the pelvis to outside your knee, where it is attached to the tibia, fibula and other tissues.
Most of the time pain is located outside the knee, but it could be on the side the thigh and sometimes feels as pain below the kneecap.
Most doctors consider the ITB syndrome cause to be overpronation and underpronation and inflexibility of muscles and tendons.
Pronation happens when the foot and ankle rotate to the medial side too much and it causes instability in the knee area where ITB resists to it. Underpronation happens when the foot doesn't move or moves too little, and by this creates stiffness, which doesn't allow to absorb the shock of landing. So the treatment of this injury consists of applying ice, changing the shoes, changing the surface of running, wearing orthotics, doing flexibility exercises, strength exercises, physical therapy. It's a long story.
From my point of view the cause of the problem is the wrong kind of movement, which starts from the wrong concepts. That's why it is very important to have the concepts right since the beginning.
Our concepts prioritize our efforts and actions and lead us to proper performance in running. Proper movement does not hurt you and it never will. The rules of the proper movement are not created in offices, but in Nature, which we have to understand, accept and execute.
One of the first rules I interpret as "never stop the movement, but redirect it".
The ITB problem is the one where this rule is broken. Any landing on the heel leads to the deviation of the GCM (General Center of Mass) from the straightforward movement, because the support foot rotates inside after landing on the heel. If you are landing on the heel, it is almost impossible to avoid pronation, except when you are not moving your weight over the lateral side of your foot and are going to have supination. In this case, and it's a pity again, overloading goes to the ITB, because of shifting your body weight in the sideways direction.
Landing on the heel or on the forefoot, but ahead of the body or in front of GCM is a brake to our forward movement.
Whether we understand it or not, the way of landing is the way of channeling of kinetic energy of the body in the desirable direction. If we allow energy to flow freely, without brakes, our body will not be harmed by our own body weight movement. So it's better to understand how to do it proper.
In the Pose Method it is achieved by the foot landing on the ground under the GCM and by allowing the body to fall forward from this balanced position.
When the body moves through this structure, there is minimum brakes for the movement of the body forward, and neither knees or hips are sliding to the medial or lateral side, so there is no load on the ITB.
Nevertheless,
if you got your ITB problem, it's better to start solving this by using strength/coordination exercises, because the ITB pain is the result of muscle disconnection.
So we need to use lateral movement of the foot with knee bent to 90 degree or less with the resistance of the partner, the rubber bend or free weights. It's better to use both eccentric and concentric regimes with the number of reps leading to the perception of muscles starting burning (it's about 20 to 30 reps in one set) and get 3 to 5 sets.
Between these exercises do an easy run, or Pose Method drills which will help you to overcome the problem sooner and get to the proper movement, which by itself will be a healing process. Once you'll get this done, you'll never get back to ITB problem again.
Dr.Romanov
