Hiking and Iliotibial Band Syndrome

Hiking and ITB

Iliotibial band syndrome, often abbreviated as ITB or ITBS, is an ailment common to hikers and backpackers, in addition to cyclists. It usually manifests itself as knee pain or pain along the side of your leg from your hip down to your knee. It occurs when the fibrous connective tissue on the outside of your leg, called the iliotibial band gets “tight” and rubs against your hip or knee bones. If you experience knee pain when hiking, it may very well be iliotibial band syndrome and not a knee injury.

What causes Iliotibial Band Syndrome?

There are many possible causes of ITB ranging from poor hydration to shoe soles that have worn down and cause your inner foot and ankle to roll inward. Another common cause is weak hip muscles as the result of sitting too much or crossing your legs over your knees when you sit: in other words, something that’s difficult to avoid if you sit for work.

The gluteus medius is the muscle on the outside of your hips, just below the iliac crest.
The gluteus medius is the muscle on the outside of your hips, just below the iliac crest.

How do you treat Iliotibial Band Syndrome?

ITB will go eventually away with rest or by taking anti-inflammatory medication. But if you hike and backpack a lot, it pays to do some remedial bodywork to prevent an occurrence.

Rolling your leg with a foam roller used to be recommended to loosen the IT band. But that fibrous connective tissue, also known as fascia, is very resistant to stretching (like don’t even bother trying) and the net result is that you can inflame the muscles surrounding it, which can also be quite painful.

One reason the IT Band gets tight is to compensate for weak muscles that surround it, especially the gluteus medius, which is the muscle on the outside of your hips, just below the iliac crest, which is what your backpack hip belt rests on and may partially cover.

How can you strengthen the Gluteus Medius?

You can strengthen your gluteus medius with a few simple exercises that are easy to do at home without any special equipment. You can make these more difficult as you get stronger using some simple elastic exercise bands or light hand weights. The following video illustrates the top exercises very well even though the narrator sounds like a certain Austrian weightlifter.

These exercises include:

  • Side-lying leg abduction
  • Pelvic drop
  • Single leg deadlift
  • Single leg squat
  • Side planks

They’ve been shown to achieve the best muscle activation: in other words, the best bang for the buck.

Can you still hike with Iliotibial Band Syndrome?

You can continue to hike and backpack although the pain usually gets more intense the longer you hike or exercise. But you can prevent the IT band from snapping against the knee bones by using an IT band wrap. This is a neoprene band with velcro at the ends that you tighten above your knee. It provides enough compression to provide some, if not total relief.

But wearing an IT band for days at a time can irritate the skin on your leg and gets pretty gross if you perspire a lot in hot weather. You really are better off doing leg strengthening exercises to prevent a recurrence. They really do work.

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