As I continue to post and consider links in the kinetic chain I am sure that I will need to change previous thoughts and ideas. I feel as though I would like to continue to share ideas as I think of them with the hope of stimulating thought and creating additional paradigms to help sleuth obstacles in our pursuit of moving better.
So without further adieu, IT-Band Syndrome… Why? Quick answer is, the stimulus of femoral internal rotation, as thought of from the ground up, is not being provided during a loading phase to trigger the hip muscular complex.
What? Well let’s look at a severe progression of IT-Band Syndrome that is a common presentation of someone seeking medical help for knee problems.
In this picture we can see the angle of the right knee pre-surgery. If you look at the tibia, it is rotated out, or rotated right. In thinking of the hip, the femur is rotated in relative to the tibia. So every time this person is loading their right leg, the Gluteus complex receives some stimulus to fire at the expense of the knee. The IT-band has adapted, or has been over-utilized, thus creating an externally rotated tibia so that the femur can internally rotate and recruit the glute.
Why would it do this? Let’s think of it in terms of the feet. If this person had a rigid foot type whereby they appear to have a high arch then the stimulus for rotation would be absent during loading of the right foot. Does this hypothesis sound crazy? Let’s look. Look at the post operative picture. Which foot has a high arch? The right foot has a high arch compared to the left. This person, if weight bearing, is in the loading phase of the right foot when the arch should be least suggesting a foot type that creates a rigid/arched foot. This person had their knee fixed surgically but did they ever look at the foot/cause?
If this is true then common foot types causing IT-Band Syndrome (or what the fellow in the picture may have) would be…
Uncompensated Rearfoot varus (rigid foot)
Rigid Forefoot Valgus (rigid foot)
Pes Cavus (rigid foot)
Reactive foot types following an externally rotated tibia seem to be more