Understanding glute strength and ITB syndrome

If you are a runner or a cyclist, understanding glute strength and your iliotibial band (ITB) so that you can avoid ITB syndrome is important. We asked our Chiropractor, Greg Sher to explain and offer management strategies should this injury take hold.

ITB syndrome is commonly seen in runners and cyclists due to the ITB’s involvement in lower body movement. The glute muscles (butt muscles for those less-science oriented) is required to work in conjunction with other muscles during movements such as running and cycling.

Gluteus Medius is one of the three main glute muscles. The main function of the gluteus medius is abduction, or moving the leg away from the body. This is a function requires co-activation of other muscle groups, such as the Tensor Fascia Latae muscle (TFL), which inserts into, and controls tension of the ITB.

The most important function of the gluteus medius is to provide stabilisation of the pelvis during single leg stances such as when running or walking. A strong gluteus medius can stabilise the pelvis on the stance leg and prevent the opposite hip from dropping downwards (known as Trendelenberg’s sign). This function is critical to maintaining good form while walking and running.

When a Trendelenberg sign is present, we also see knee valgus (the knee moves inwards towards the opposite knee), which creates tension and friction at the knee and hip joint due to the attachment of the Iliotibial band.

ITB syndrome is considered by most to be an overuse injury most commonly seen in runners and cyclists. A common symptom is a “snapping” sensation of the hip when the knee flexes and extends during the running motion. However, some people can experience debilitating lateral knee pain, where the ITB inserts on the patella (knee cap) and tibia. Here, the thick fascia becomes inflamed from the friction of rolling over the lateral femoral condyle, located within the knee joint.

There are a variety of different management strategies for this particular syndrome. Ensuring appropriate footwear is important. This is where a good running assessment is required!

If you are a cyclist, a correctly fitted bike is also very important. The saddle height and cleat position need to be balanced to ensure optimal position of the knee through a repetitive peddle stroke.

Manual therapy to the pelvis and hip joints, stretching, massage, rest (i.e. cross training/running in water…), strengthening of gluteus medius and other muscles and tendons in the functional kinetic chain, have all been reported to be successful interventions. If conservative care fails, further referral to a Sports Physician may be indicated.

Carrying out a functional assessment to correct any imbalance between muscle groups such as hamstrings and quadriceps, or hip abductors (including gluteus medius) and hip adductors (groin) can also prove very useful. Weakness of any of these muscles around the hip, pelvis and knee will contribute to both the severity and chronicity of this syndrome.

Essentially, a strong gluteus medius muscle means a more efficient running style, which will improve performance, decrease the likelihood of any hip or knee injury, and keep you running further, for many years to come!

Chiropractors specialise in optimising the function of the spine by improving posture and movement, helping to improve many aspects of your health.

Call us to book an appointment to see Dr. Greg Sher, M-Chiro (RSA), D.C. (UK)

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