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Iliotibial Tract Questions
I have a client with an extremely tight IT band that causes pain during his workouts. He does daily intense workouts. While he's stretching, it's not really enough and he ends up cramping up. Any ideas on working the IT band and/or stretching it? Thanks!
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Replies to This Discussion
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Permalink Reply by Julianna Holden Mohler on
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2 words for you as a massage practitioner: Trigger points. For him, foam rollers that release trigger points and fascia. I never found any amount of stretching, massage or deep tissue to help this. Energy work by using trigger points did the trick for me.
Posture is another issue, and it often involves the quads and low back that need to be released - perhaps even the calves.
When does he cramp up? During the stretching, during or after his intense workouts? After he's cooled down? Does he stretch before and after his workouts?
Cramping is usually a magnesium deficiency, so epsom salt baths can help, but also supplements. Of course, it often means not enough fresh, raw vegetables in the diet. Focusing on protein and acidic foods also contribute to cramping.
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Permalink Reply by Kelly Lindsay on
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Look at releasing the muscles around the IT band. I work with lots of marathoners and being a massage therapist at the gym, see people with this issue all the time. It's usually the muscles around, under the IT Band. You can't really do any neuromuscular on the band itself or intense bruising will occur. Also, I always suggest to clients to vary their workouts or take a break from the routine which is causing the pain. I also tell them to use foam rollers on the lateral side of the legs, for self preservation.
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Permalink Reply by Stephen Jeffrey on
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Hi Misty
I focus on releasing hypertonicity in the quad group first, but lateralis moreso by deep stripping and Triggerpoint work then look for adhesions on Illiac crest and tibia attachments of ITB (friction work) then go to TFL and Gleute max insertion points into ITB, these will be very tender to work, so start gentley and identify Triggerpoints and release v slowly.
If your client is experiencing runners knee then he may need tapeing and rest.
For some reason sporty types seem to think more pain more gain which is totally unessesary ..........but on the other hand if they feel they "must have" the pain the above area's are easily activated.........
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Permalink Reply by Misty Van Staaveren on
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Thank you everyone! REally great tips. I'll be sure to let you know how our next session goes! Thanks for your help!
Misty
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Permalink Reply by lee kalpin on
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It would help to have an explanation of what he means by "cramping up". Does he get actual muscles spasms? When? During the stretches? After?
Sometimes when clients use this term they mean that they stiffen up after a workout. There is a big difference between a muscle cramp or spasm, and stiff muscles.
The next point is, does he have tight IT band on one leg, or both legs? If it is one side only, then there is a postural or gait imbalance.
Important to find out what is really happening here. then there will be a more clear answer as to what treatment to follow.
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To add to my last post - IT band is the continuation of the gluteus maximus and tensor fascia lata muscles. The IT band itself is connective tissue and has no contractile ability. It is the muscles that are pulling it tight.
lee kalpin said:It would help to have an explanation of what he means by "cramping up". Does he get actual muscles spasms? When? During the stretches? After?
Sometimes when clients use this term they mean that they stiffen up after a workout. There is a big difference between a muscle cramp or spasm, and stiff muscles.
The next point is, does he have tight IT band on one leg, or both legs? If it is one side only, then there is a postural or gait imbalance.
Important to find out what is really happening here. then there will be a more clear answer as to what treatment to follow.
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He says that he is cramping up during his workout sessions. Weirdly enough it's when he's doing other type of work like ab work, not necessarily his legs. The exercises he's claiming cause him to cramp up are where you lay on your back with your legs up and raise your hips off the floor. From what it sounds like to me is like a charley horse, then he's really sore afterwards. Anytype of pressure causes him to wince so I can barely work the muscles in the quadricep area, specifically vastus lateralis. He's applied heat to it and it helped but it always comes back. It's mostly his left quad but both his IT bands feel like a rock. He admits he stretches, but not enough. I usually try to do some stretching with him on the table as well. Hope that helps a bit. Thanks for everyone's input!
Misty
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There are a few possible explanations. As I said, a true muscle CRAMP or spasm, is very different from sore muscles. A spasm has a neurological cause. The muscle suddenly tightens uncontrollably to its maximum contraction, and very painfully and is very difficult to release. It's difficult to tell from the description if this is what is happening to your client.
If it is a true muscle spasm, you need to look at nutritional deficiencies.
The nutrients involved in muscle contraction are calcium, potassium and sodium. If any of these are depleted it will cause spasms. Sometimes it is not actually a "deficiency" - if someone is working out extensively they may be using their nutrients more quickly and may become depleted. Although most people eat more than enough salt (sodium), athletes sometimes perspire so much that they lose a great deal of sodium, plus they drink a lot of water so there may be a lot of sodium loss. This will cause an athlete to go into spasm during a workout.
Potassium is depleted if there is excessive loss of body fluids, such as diarhhea or excessive urination if a person takes "water pills". Calcium is of course derived mostly from milk products, and needs magnesium and Vitamin D to be absorbed into the muscles and bones.
I think it would be a good idea to discuss these diet concerns with your client
The exercise you are describing does not seem to be one that uses quads specifically- more of an abdominal exercise. But if he uses his quads a lot during his other exercises, they will be prone to spasm. It is usually the muscles in t he feet and legs that spasm due to nutritional deficiencies. Doesn't sound as if it is lack of stretching because he is not contracting the quads when they go into spasm.
All the advice is good, but I would have him seriously look into possible nutritional causes.. .
Misty Van Staaveren said:He says that he is cramping up during his workout sessions. Weirdly enough it's when he's doing other type of work like ab work, not necessarily his legs. The exercises he's claiming cause him to cramp up are where you lay on your back with your legs up and raise your hips off the floor. From what it sounds like to me is like a charley horse, then he's really sore afterwards. Anytype of pressure causes him to wince so I can barely work the muscles in the quadricep area, specifically vastus lateralis. He's applied heat to it and it helped but it always comes back. It's mostly his left quad but both his IT bands feel like a rock. He admits he stretches, but not enough. I usually try to do some stretching with him on the table as well. Hope that helps a bit. Thanks for everyone's input!
Misty
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