IT band, piriformis, carpal tunnel, The Incredibles – what do these all have in common?
SYNDROME. We have a Syndrome Syndrome because of how frustrating it is to see someone with an “xyz” syndrome.
A syndrome is just a collection of symptoms, meaning there a bunch of things going on, but no one really knows what the root of the issue is, so it’s a diagnosis of exclusion.
IT Band Syndrome
One of the most common syndromes is IT band syndrome, and it’s not what most people think. The IT band is such a strong structure that to really “stretch” it, you would have to rip it out of your body and hang an elephant from it to begin to feel a stretch.
When people complain of IT band syndrome, they are typically referring to a pain that originates around their outer hip, near the glute region, and goes down toward the outside, or lateral, part of the knee.
The pain point varies from person to person, but can either be at the knee or hip, or somewhere within those two points. In physical therapy, we tend to see this IT band syndrome diagnosis in runners, athletes who do a lot of squatting, or those doing a lot of repetitive movements.
Tale of Symptoms
It’s important to address the symptom behavior rather than the label “syndrome” itself. When you start realizing that you have control over how you move and that how you move effects how you feel and is a factor in your pain, you are much better set up to be able to guide yourself through rehabilitation. Your goal is to move pain free once again.
Location, Location, Location
When patients come to us with pain on the lateral part of their knee, our immediate thought is not “IT band syndrome;” rather, we think about what could possibly be causing those symptoms in that area. The IT band originates at the hip as two muscles: the tensor fasciae latae muscle and the gluteus maximus.
When something is off kilter with one of those two muscles, it will throw off the tension in the IT band, so the IT band essentially becomes an innocent bystander, between a rock and a hard place, the muscles and the attachment at the knee.
A bothersome IT band has very little to do with the IT band itself, but rather your overall movement and possibly irritation coming from the hip or low back. Since the problematic origin is at the hip, we would look at the hip and the low back. We would also look at several different movements, such as a squat or a lunge, to identify what is throwing off that normal range of motion. Once we run a patient through these movements, we are able to get a clear picture and we get rid of that IT band syndrome diagnosis.
Remember, where pain is doesn’t equal what it is. In other words, don’t be fooled by the location of your pain.