ITB Pain

Today’s blog has come about from a conversation I had with a friend of mine who is running the marathon. Like many runners when they get beyond then 10 mile mark he has been struck down by IT band pain.

After consulting the physio he was given some classic stretches for this. General hip ADuction off weight bearing etc. This got me thinking about the predominant view of muscle function and how if we length or strengthen a muscle then it will do this by default.

First of all the ITB and muscles that attach to it maybe individually fine, but when they interact with the foot in a functional position such as stride stance this may change.

A flat or high arched foot may cause excessive lengthening or a lack of lengthening of the IT band and associated muscles. However much we lengthen or strengthen these muscles in isolation, when placed in a functional chain they will be limited or affected by other sections of the chain e.g. the foot. This means that in isolation and decompressed from gravity these muscles will appreciate the stretch but this may make little difference to their ability when back in a functional position during such as during running.

Many times I have treated people who have foam rolled and performed all manner of stretches in an isolated way but to no avail. Once we have found a cause rather than a symptom they have become much better.

The real point here is just because we spend time lengthening or shortening a muscle it may not choose or be able to use the motion or strength we have given it in a functional scenario. It maybe that another part of the system will not allow it to or the muscle or group of muscles have to perform another role because another part of the body has not done its job.

Another example of this would be kyphosis. People send hours retracting the scapulae to ‘strengthen’ the muscles of the upper back but their postures never change. This maybe because something further down the chain such as the hips and ankles are not able to effectively flex and attenuate the ground reaction and gravitational forces. This means the upper back will have to lengthen to decelerate the spine flexing forward so that the neck and head can remain in a relative upright position. In this scenario would these muscles choose to lengthen and decelerate motion to create relative upper thoracic and cervical extension or, shorten and force the superior distal segments at the cervical to lengthen disrupting head/eye function. I believe the latter regardless of the ‘strength’ we have given them. One thing we cannot ‘beat’ or get away from is gravity and ground reaction (unless you have a spaceship of course!!!)

This maybe a reason why people with limited thoracic motion get an anterior head position. The inability of the spine to relatively extend means the neck muscles have to decelerate the forces and end up at lengthened and at end range.

Just some thought out loud really!!!!

Ben

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