Muscle Of The Month: Iliotibial Band (ITB)

The iliotibial band (ITB) or iliotibial tract is a thick strip of connective tissue that runs down the outer thigh from the hip (the ilium) to the knee (the tibia). While not a muscle, the ITB attaches to and works in conjunction with the Tensor Fascia Latae (TFL) muscle and the gluteal muscles.

Categorised as a deep fascia, the iliotibial band is formed of dense connective tissue, including collagen fibres, characterised by strength and toughness.

While personal trainers and other qualified fitness professionals will have studied anatomy, for many people, the first time they hear of the iliotibial band is when they are diagnosed with ‘a tight IT’, ‘runner’s knee’ or ‘ITBS’ (iliotibial band syndrome). This is a knee injury caused by the overuse of the ITB, widespread among runners, cyclists, and those who repeatedly overdo squats in their training routine.

THE ORIGINATION AND INSERTION OF THE ILIOTIBIAL BAND

The Iliotibial band originates from the origin of the gluteal muscles, at the posterior iliac crest of the pelvis, and the tensor fascia latae at the front of the top of the thigh. It runs down the outside of the thigh, over the greater trochanter, and inserts below the knee into the top of the tibia (shinbone).

THE ACTION AND BASIC FUNCTIONAL MOVEMENT OF THE ILIOTIBIAL BAND

Connecting the muscles at the top of the thigh to the shinbone, the iliotibial band is essential for the movement of the thigh and knee.

It serves the following functions:

• hip abduction (the prevention of hip adduction)
• medial rotation and flexion of the thigh
• knee flexion
• knee extension
• stabilising the lateral part of the knee

COMMON EXERCISES FOR THE ILIOTIBIAL BAND

Most exercises geared around the ITB are designed to stretch the TFL and strengthen the hip and gluteal muscles, as this prevents the TFL from pulling on the ITB, making it too tight and risking ITBS (see below).

A qualified personal trainer will be able to design a suitable training programme for you, which may include some or all of the following:

• side leg raise
• hip thrust/bridge (two-legged or one-legged)
• hip hike
• side hip bridge
• pistol squat
• Single-leg balance

Those with ITBS can also benefit from using a foam roller and applying self-myofascial release (SMR) – again, following advice from a fitness professional.

PROBLEMS ARISING FROM DAMAGE TO THE ILIOTIBIAL BAND

As mentioned, the iliotibial band is prone to injury due to tightness and inflammation resulting from overuse. This is known as Iliotibial band syndrome (ITBS) and only affects the lateral side of the knee, just above the knee joint.

It’s an injury familiar to many runners, especially those who train on the same side of a road camber or frequently run on hills. However, it also affects cyclists, rowers, and others who carry out repeated squats as part of their training routine, such as weightlifters. Some athletes are more anatomically predisposed towards developing ITBS.

While RICE (rest, ice, compression, elevation) can help with an iliotibial band injury, exercising the surrounding area to strengthen it is a good way to avoid ITBS in the first place.

CONCLUSION

Although not a muscle, the Iliotibial band plays a crucial role in connecting muscles around the hip and knee, and is vital in facilitating movement of the hip, thigh, and knee. As iliotibial band syndrome is relatively common, runners and other athletes can benefit from following exercise programmes designed by fitness professionals to help prevent this injury or recover from it.