Once again, we're in the midst of another Holiday Season and everything that comes with it- friends, family, relaxation, and of course, great food! If your family is anything like mine, you spend your holidays sitting around a table eating, visiting, re-hashing old stories(usually the same ones you told last year, and the year before, and the year before...), then eating some more. And then dessert comes out! We spend more time indulging, reminiscing, and mostly expressing our feelings of guilt for eating way too much. What a way to spoil the holiday!
Let's break this cycle in the New Year. No, I'm not going to tell you to never touch another dessert, or that it's never OK to indulge every now and then- especially on those ever-important annual holidays and gatherings!
I'm suggesting we change our approach. These times should be considered rewards- rewards for all of the hard work, exercise, and responsible diet choices we've put in throughout the year. Expecting yourself to never touch another dessert again and then experiencing the dooming feeling of guilt every time you "slip up" does nothing but set you up for failure. Life's too short not to enjoy. Work hard in your fitness programs, make wise food choices throughout the week, and reward yourself with a little indulgence every now and then... within reason!
Happy Holidays!
Tuesday, December 29, 2009
Sunday, November 22, 2009
IT Band Syndrome; Is “IT” Really the Problem?
Are you like most of us runners who have “tight IT bands,” and even pain? Have you even gone so far as to be diagnosed by a doctor as having “IT Band Syndrome?” IT Band tightness and pain is one of the greatest “epidemics” facing our running community today. It seems like every runner I’ve met complains about at least some IT band tightness, and usually pain either in their lateral thigh, or knee, or both. At the same time, it seems that every runner I’ve talked to with this problem has gone through great lengths to alleviate it- rigorous stretching routines pre and post runs, massage, acupuncture, and any other type of holistic body-work, and even physical therapy. For each of the people, all of these treatment options have helped, but for most, it turns into a way to manage it so they can survive their runs versus actually taking care of the problem.
This raises the golden question: “If having a ‘tight IT band’ is the problem, then why doesn’t all of the stretching and body work I do fix it?” I’ve learned to answer that question with another question: “Is having a ‘tight IT band’ actually the problem, or is it a symptom of the problem?” In most cases, the answer is “Yes.” Yes, you have a tight IT band, which is a problem, and yes, IT band syndrome is usually the symptom of a greater problem: Improper body mechanics and muscle dysfunction.
Our bodies are amazingly designed machines, capable of performing amazing feats. But, like any machine, our joints and muscles rely on the laws of physics (angles, pulleys, and levers) to properly propel us in the direction we want to go. Just the slightest inconsistency in a muscle’s strength, or group of muscles’ firing pattern, or a slight change in joint angle will alter our mechanics just enough, and cause unnecessary wear and tear.
Any time a muscle or tissue is tight, there is a reason. It could be that you had a tough workout the day before and the fatigue and lactic acid build up causes a little extra tightness. But, if you stretch that muscle, and that tightness is alleviated, only to return later on, logically, one would think there is something causing that muscle to tighten again. Typically a tight muscle or tissue is the result of a fatigued and overused muscle- overworked because another muscle isn’t doing its job. This is the case with IT band syndrome.
The IT band, itself, is not a muscle. It is what its name suggests: a band of connective tissue. Its main function is to provide lateral support for our hip and knee. The IT band does attach to a muscle called the tensor fasciae latae (TFL). The TFL is a small triangular muscle that attaches on the crest of our pelvis (Illium), and turns into a long band of connective tissue that attaches on the outside of our inner shin bone (+Tibia= IT band). The main function of the TFL is to support the gluteus medius muscle in maintaining a level pelvis when we are standing on one foot, or helping raise our leg sideways (abduction). The key word is support. It is too small to perform this task all by itself. The TFL and IT band become overworked and tight when the gluteus medius does not fire sufficiently to maintain a level pelvis while we are on 1 foot in the “mid-stance” phase of the running gait.
The gluteus medius is one of the main stabilizers of the pelvis. It is responsible for keeping your hips level when you land on one foot, and also assists in the hip extension, or “push-off” that propels you forward. If the gluteus medius doesn’t fire sufficiently when your heel first strikes the ground, the pelvis will “shift,” and the opposite hip will actually drop a little lower than the stance side. Once that happens, a “C-Shaped” curve will appear through your mid section, and the TFL and IT band are left to “catch” your pelvis, along with the weight of your entire upper body. This tiny, triangular band of muscle is left to do the work of one of the most powerful muscles in the body. Once this happens, repetitively throughout the thousands of steps you take during your run, the TFL and IT band are trained to remain rigid and “spasmed,” working overtime in an attempt to maintain that pelvic stability. This tight, spasmed tissue causes extra friction on the outside of the quad, above the knee, and also will tend to pull on the knee cap, causing improper tracking and knee pain. It doesn’t matter how much you stretch your IT band, quads, glutes, or whatever. If the gluteus medius isn’t doing its job, the TFL and IT band will go right back to where it was once you start running, and eventually just walking, again.
So, why does my glute stop working, and what can I do about it? There are many reasons why the gluteus medius stops working, or gets weak. Some of the better known reasons are anatomical: leg length discrepancy, poor pelvic alignment, flat feet, high arches, etc. Each of these affects the physics of your joints, and lead to improper glute firing. Consulting with a physical therapist to deal with these issues is advised. If you’ve addressed these issues, and continue to have problems, then you haven’t totally fixed the problem. Once your joints are aligned properly to allow that glute to fire, you still need to put in the hard work of strengthening, and “reprogramming” muscle firing patterns to ensure things are happening in the correct sequence.
Another cause for this weakness could be from a lack of diversity in your workouts, relating to “planes of movement.” As mentioned before, the gluteus medius is not only responsible for maintaining a stable pelvis when moving straight ahead, but also raises the leg to the side, which translates into moving side to side. Most runners are straight ahead athletes. We seldom actively move “side to side.” Most of our cross training tends to be swimming (straight ahead), cycling (straight ahead), elliptical machines (straight ahead), etc., etc. Do you see the pattern?
There have been articles upon articles written on stretching, and its importance, so I’ll spare you the proverbial “beating of a dead horse.” If you’re not stretching, that’s your first action step. Otherwise….
One of the easiest ways to strengthen and activate the gluteus medius is to run (or move quickly) laterally. How many basketball players, soccer players, or football players do you know, or heard of, have “IT Band Syndrome?” They put in just as many training hours, or more as we do (albeit a little differently), but rarely have IT band tightness or pain. Try throwing in a recreational basketball game or ultimate Frisbee game into your weekly routine and see if that helps!
Another effective way, that’s almost so obvious that it frequently gets overlooked, is strength training. Running alone is not enough to actually strengthen your muscles, or retrain a movement pattern. Getting to the gym and doing the basics- squats, deadlifts, lunges, rows, presses, and core exercise is the most effective way to correct your problem. All of these exercises, done properly, address the muscles along with the movement patterns that we use continually in running. Doing these simple exercises with appropriate form and with a sufficient load should put you on the fast track to recovery. They can be done unilaterally (one leg/arm) or bilaterally (both legs/arms)- each is beneficial.
Continuing to run, hoping that alone will help you get stronger is an act of futility. After all, you’ve been running for how long? And are you strong enough to stop your IT Band problems yet? What’s the definition of insanity? “Repeating the same thing over and over, expecting different results.” Take a big step and make the tough decision to decrease your mileage, or take some time off of your running to strengthen appropriately. Replace 2-3 of your running days with strengthening days. Add a light run after your trip to the gym if you absolutely have to. The return on investment is undeniable- stronger muscles with proper movement patterns will allow you to continue (or resume) your running career with much less pain and even more efficiency. What are a few weeks if it allows you to continue on with years of happy running? Once the movement patterns are corrected and the muscles are strengthened, some simple maintenance (1-2 days/week) is all you’ll require to keep you on the road.
This raises the golden question: “If having a ‘tight IT band’ is the problem, then why doesn’t all of the stretching and body work I do fix it?” I’ve learned to answer that question with another question: “Is having a ‘tight IT band’ actually the problem, or is it a symptom of the problem?” In most cases, the answer is “Yes.” Yes, you have a tight IT band, which is a problem, and yes, IT band syndrome is usually the symptom of a greater problem: Improper body mechanics and muscle dysfunction.
Our bodies are amazingly designed machines, capable of performing amazing feats. But, like any machine, our joints and muscles rely on the laws of physics (angles, pulleys, and levers) to properly propel us in the direction we want to go. Just the slightest inconsistency in a muscle’s strength, or group of muscles’ firing pattern, or a slight change in joint angle will alter our mechanics just enough, and cause unnecessary wear and tear.
Any time a muscle or tissue is tight, there is a reason. It could be that you had a tough workout the day before and the fatigue and lactic acid build up causes a little extra tightness. But, if you stretch that muscle, and that tightness is alleviated, only to return later on, logically, one would think there is something causing that muscle to tighten again. Typically a tight muscle or tissue is the result of a fatigued and overused muscle- overworked because another muscle isn’t doing its job. This is the case with IT band syndrome.
The IT band, itself, is not a muscle. It is what its name suggests: a band of connective tissue. Its main function is to provide lateral support for our hip and knee. The IT band does attach to a muscle called the tensor fasciae latae (TFL). The TFL is a small triangular muscle that attaches on the crest of our pelvis (Illium), and turns into a long band of connective tissue that attaches on the outside of our inner shin bone (+Tibia= IT band). The main function of the TFL is to support the gluteus medius muscle in maintaining a level pelvis when we are standing on one foot, or helping raise our leg sideways (abduction). The key word is support. It is too small to perform this task all by itself. The TFL and IT band become overworked and tight when the gluteus medius does not fire sufficiently to maintain a level pelvis while we are on 1 foot in the “mid-stance” phase of the running gait.
The gluteus medius is one of the main stabilizers of the pelvis. It is responsible for keeping your hips level when you land on one foot, and also assists in the hip extension, or “push-off” that propels you forward. If the gluteus medius doesn’t fire sufficiently when your heel first strikes the ground, the pelvis will “shift,” and the opposite hip will actually drop a little lower than the stance side. Once that happens, a “C-Shaped” curve will appear through your mid section, and the TFL and IT band are left to “catch” your pelvis, along with the weight of your entire upper body. This tiny, triangular band of muscle is left to do the work of one of the most powerful muscles in the body. Once this happens, repetitively throughout the thousands of steps you take during your run, the TFL and IT band are trained to remain rigid and “spasmed,” working overtime in an attempt to maintain that pelvic stability. This tight, spasmed tissue causes extra friction on the outside of the quad, above the knee, and also will tend to pull on the knee cap, causing improper tracking and knee pain. It doesn’t matter how much you stretch your IT band, quads, glutes, or whatever. If the gluteus medius isn’t doing its job, the TFL and IT band will go right back to where it was once you start running, and eventually just walking, again.
So, why does my glute stop working, and what can I do about it? There are many reasons why the gluteus medius stops working, or gets weak. Some of the better known reasons are anatomical: leg length discrepancy, poor pelvic alignment, flat feet, high arches, etc. Each of these affects the physics of your joints, and lead to improper glute firing. Consulting with a physical therapist to deal with these issues is advised. If you’ve addressed these issues, and continue to have problems, then you haven’t totally fixed the problem. Once your joints are aligned properly to allow that glute to fire, you still need to put in the hard work of strengthening, and “reprogramming” muscle firing patterns to ensure things are happening in the correct sequence.
Another cause for this weakness could be from a lack of diversity in your workouts, relating to “planes of movement.” As mentioned before, the gluteus medius is not only responsible for maintaining a stable pelvis when moving straight ahead, but also raises the leg to the side, which translates into moving side to side. Most runners are straight ahead athletes. We seldom actively move “side to side.” Most of our cross training tends to be swimming (straight ahead), cycling (straight ahead), elliptical machines (straight ahead), etc., etc. Do you see the pattern?
There have been articles upon articles written on stretching, and its importance, so I’ll spare you the proverbial “beating of a dead horse.” If you’re not stretching, that’s your first action step. Otherwise….
One of the easiest ways to strengthen and activate the gluteus medius is to run (or move quickly) laterally. How many basketball players, soccer players, or football players do you know, or heard of, have “IT Band Syndrome?” They put in just as many training hours, or more as we do (albeit a little differently), but rarely have IT band tightness or pain. Try throwing in a recreational basketball game or ultimate Frisbee game into your weekly routine and see if that helps!
Another effective way, that’s almost so obvious that it frequently gets overlooked, is strength training. Running alone is not enough to actually strengthen your muscles, or retrain a movement pattern. Getting to the gym and doing the basics- squats, deadlifts, lunges, rows, presses, and core exercise is the most effective way to correct your problem. All of these exercises, done properly, address the muscles along with the movement patterns that we use continually in running. Doing these simple exercises with appropriate form and with a sufficient load should put you on the fast track to recovery. They can be done unilaterally (one leg/arm) or bilaterally (both legs/arms)- each is beneficial.
Continuing to run, hoping that alone will help you get stronger is an act of futility. After all, you’ve been running for how long? And are you strong enough to stop your IT Band problems yet? What’s the definition of insanity? “Repeating the same thing over and over, expecting different results.” Take a big step and make the tough decision to decrease your mileage, or take some time off of your running to strengthen appropriately. Replace 2-3 of your running days with strengthening days. Add a light run after your trip to the gym if you absolutely have to. The return on investment is undeniable- stronger muscles with proper movement patterns will allow you to continue (or resume) your running career with much less pain and even more efficiency. What are a few weeks if it allows you to continue on with years of happy running? Once the movement patterns are corrected and the muscles are strengthened, some simple maintenance (1-2 days/week) is all you’ll require to keep you on the road.
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