Hi, it's Dr. Centeno.
And today, we're going to talk about what is the ITB,
and why does mine hurt all the time?
Well ITB stands for iliotibial band.
If you break that down into its two component parts,
the ilio part refers to the ilium at the side of the hip,
and the tibial part refers to the tibia
at the side of the knee.
So iliotibial band is just a band
that goes all the way from the hip to the knee,
and it looks something like this.
So I've highlighted the ITB in red there.
I'm going to go ahead and get the pointer going.
It's a band that actually on this side, on the hip side,
connects in with some big muscles.
The glute max muscle pulls this way on the band itself,
and the TFL muscle pulls that way.
So we have this band at the side of the hip that
goes all the way to the knee, and these muscles yank on it.
So what could that be for?
Why is it there?
Well, if you look at the biomechanics of this thing,
it's really interesting.
Because as I just showed you, it goes all away
from the hip to the knee.
So from the hip to the knee.
And these muscles pull on it both from the front end
and the back.
And if you look at someone standing
from the back, what happens when they raise the other leg?
When they raise the left leg, it's
actually the muscles on the right,
in the side of the hip that support the pelvis that
keep that pelvis stable.
So those muscles pull this way, and that yanks on here.
And then obviously, the foot is the anchor.
So all of that provides a force couple, if you will,
to keep the pelvis from tilting when you lift the other leg.
Now, if these muscles here are weak,
then the whole thing tilts when you
lift the other leg, because they don't have enough force
to hold everything up.
And that's a pretty important thing to understand,
if you have problems in the ITB.
So if we were to look at the biomechanics here again,
just looking from the side, this thing
goes all the way down from the hip to the knee.
It's commonly painful right here at the side of the hip,
but a lot of patients have pain that goes all the way down.
Again, they're these big muscles that attach right here
and yank on it that support the whole pelvis and hip when
you lift the other leg.
So if we draw in the ITB here, we
can see that we have these big muscles on the side.
And then we have the ITB going all the way
from the hip to the knee.
Now, what's really important is that there are nerves that
actually supply those muscles.
And those nerves that come from your lower back.
And the nerve supply goes this way,
and the nerves tell the muscle what to do.
Now, if the nerves get irritated in your back,
even though you might not have back pain, or much back
pain to speak of, or maybe you have a lot, who knows?
But in either instance, if a nerve
is irritated back in here, this muscle's
going to have less nerve supply, and the muscle
is going to get weaker.
And that's then going to wreak havoc,
as you might begin to see.
So if you look at the biomechanics of this thing,
again when you've got one leg lifted here, what ends up
happening is the pelvis wants to obviously tilt down
this direction.
But it doesn't, because this muscle contracts.
Now, what would happen, again, is if this muscle over here
was weak because of nerves that were pinched in the back going
to it, you're going to get the pelvis drop when
you lift this leg.
But you lift this leg a lot, obviously.
You lift this leg when you run, you
lift this leg when you walk.
That's called stance phase.
So basically, what's going to happen
is that this iliotibial band is going
to get yanked on in that situation, when
the muscles on this right side are weak.
So we're going to see pain along the iliotibial band.
The iliotibial band wasn't built to withstand
that kind of extra yanking force from the muscles being weak.
In addition, as you can see here,
if you've got a scoliotic curve in your spine,
that's also going to shift or push the pelvis
down on one side and up on the other side, which
is also going to stretch out that iliotibial band and cause
pain.
So either a pinched nerve in the back
for a change in the curvature of the side bending
of the spine, scoliosis, can cause these issues.
Also, if you're knock kneed or bow legged,
you can experience very similar things.
As you might imagine, in either one of these situations
you can get extra force placed on the iliotibial band.
In addition, a lot of times patients
will report a snapping iliotibial band
at the side of the hip.
And if you've got any extra force on the tibial band
and this side of the hip area where it goes over
what's called the greater trochanter get swollen,
it's going to snap.
So that's what causes snapping hip.
So if your RFT hurts despite countless stretches,
you may want to have someone take a look at your low back,
and whether a pinched nerve there
may be making the butt and hip muscles weak.
Again, you don't necessarily have
to have severe back pain to qualify to be in this category,
just subtle nerve issues that are causing weakness
in the muscle, and it's showing up
as a really pissed off iliotibial band.
Well, thanks for watching.
That's just a quick lesson about what the ITB is,
and what you might want to look at if you've got this problem.
Thanks.