Tuesday 17 May 2016

IT Band pain and my lazy glute

I'm writing this on day 3 of having the most pain thighs, walking especially up and down stairs is a real challenge, even touching them is a sore point.  How did I end up in such a state?  A conditioning class on Thursday!!! I'm not exactly sure which exercise did the deed or if it was a combination of exercises, but come Friday morning I was walking like a very bad low budget 70's robot!  And it hasn't improved much yet either.

The actual problem is my IT Band (ITB), the ligament that runs down the outside of your thigh that begins up by your hips (where it connects with the Tensor Fascia Lata, sorry getting technical here) then runs down to the knee and onwards onto the shin.  Doing alot of physical activity for the first time, or changing the type/intensity of exercise that you do pushes the body to do things differently and can result in muscle soreness (yeah right, these thighs of mine BURN baby, burn!!)

The popular misconception is that as a result of this your ITB tightens, me included and I advised clients accordingly.  The latest studies show that rather than tightening, our ITB's are actually getting "glued" to a muscle below it with the friction between them being the cause of discomfort.

There are a few reasons why this happens; problems with the knees, unbalanced hamstrings (I have issues in this area), a tight piriformis (those of you who have had massage with me know that I target this often painful deep muscle in the bum with my elbow), or a a glute muscle, the medialis, that isn't working as it should, allowing it to weaken, forcing other tissues such as the ITB to take over.  As a result your body automatically uses these other structures to move leaving the poor glute to longer in obscurity.  Are you still with me?  Basically my ass has gotten lazy!!

In the past to relieve my ITB pain, I'd be on that foam roller, frantically hammering away at my ITB, biting my lip and swearing through the pain I was experiencing because it's all worth it to have a freed up ITB.  I apologise to all clients who I advised to follow my lead because, guess what?  We've probably been doing more harm than good.  Yes, rolling some parts of the body is great for increasing mobilisation of tissues but not necessarily the ITB where we could be stretching an already over stretched and abused piece of tissue.So stop abusing your tissues and join me in waking up your lazy glute.


Here's a simple glute med test to see if yours is or isn't working properly, you may need assistance for this;
 Lay down on your side in a straight line and make sure your hips are stacked on top of one another. Now with your legs out straight bring your top leg, whichever it may be, back a bit so that your toe is touching the heel of your bottom foot. Now flex your ankle and try to raise your leg.

Many people have trouble even performing this leg lift without rolling backwards (which allows you to cheat with your hip flexors), turning the foot outwards (which allows you to cheat with your external rotators) or letting the leg shift forwards (which lets you use your hip flexors again). So if you’re able to do this you’re already ahead of roughly 50% of the population.

Now have your friend attempt to push your leg down gently at first and then with slightly increasing force. If you can maintain the height of your leg without your body position shifting, then congratulations, your hip abduction is actually quite strong. For most of us, we will either resort to cheating or simply be unable to maintain the leg raise.


The nice thing about this issue is that it can be fixed pretty easily. The same leg lift you used as a test can be used as an initial exercise to reteach your glute med to fire. You simply need to pay close attention to avoid cheating and make sure you feel the muscle pulling.  If you start to feel the pull on the front of your hip, then take a break and adjust your position because you’re cheating.

I mentioned a tight piriformis earlier. If you feel tightness in the fleshy part of your bum when yu get into a position similar to this, chances are yours is tight.  It can be the cause of sciatic or lower back pain.

To help relieve yours between sessions with me, try these simple stretches and hold for up to a minute.




As with most movement disorders the true solution is mindfulness of your body position and mindfulness of your movements. Get your glutes firing again and maintain mindfulness of their proper use while working out. It really is that simple.


Til next week, stay safe 
MB

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