The most commonly cited reason for stretching the iliotibial (IT) Band is to alleviate knee pain. Before we can state the best way to stretch it, we need to talk about what the IT band is, and then how it influences knee pain.
What is the IT band?
It’s imperative to note the IT band is not a muscle. I’m not sure if people realize this or not, but based on the way people talk about it, and talk about stretching it, I’m pretty sure people often think the IT band were like any other muscle.
It’s not.
Multiple muscles insert into the IT band. So rather than the IT band being a muscle itself, it is a band made of other muscles. The two big muscles comprising the IT band are the gluteus maximus (GM) and tensor fascia latae (TFL).
From Anatomy Trains by Tom Myers. (Get this book!)
It is crucial to understand the TFL and GM comprise different portions of the IT band. The TFL comprises the anterior portion and the GM the posterior portion.
Using the Anatomy Trains philosophy from Tom Myers, we can see while the GM and TFL insert into the IT band proximally (starting at the hip), other muscles insert into the IT band distally too (at the knee).
Credit to Anatomy Trains and Tom Myers
The anterior portion of the IT band connects into the tibialis anterior (TA) while the posterior portion connects into the peroneus longus (PL). Therefore, there is a connection between the TFL and the tibialis anterior, and another connection between the GM and peroneus longus. And all of these insert into one band.
How does it influence knee pain?
This is where it gets a little messier.
The most common cause of knee pain is an imbalance between all these muscles acting on the IT band. Specifically: the TFL is overactive and tight, but the tibialis anterior is underactive and long (remember these two muscles are connected on the anterior portion of the IT band). And then the peroneus longus is overactive and tight, but the GM is underactive and long (these two are connected on the posterior side of the IT band).
By looking at these muscles specific actions we can begin to figure out how pain arises. At the hip, the TFL abducts, flexes, and internally rotates the femur. It also laterally rotates the tibia.
Meanwhile, the GM has almost the complete the opposite effect: Hip extension, lateral rotation of the femur and some possible internal rotation of the tibia.
That is, the TFL and GM have almost completely opposing actions at the hip and knee. This is why most often when one is strong/tight, the other is weak/long.
At the knee: Peroneus longus pronates and plantarflexes the foot and has some effect on lateral rotation of the tibia.
The tibialis anterior helps to supinate and dorisflex the foot and internally rotate the tibia.
That is, the PL and TA have opposing actions at the knee and ankle. In fact, these muscles not only insert at the IT band, they actually form a band together at the bottom of the foot!
Credit to Anatomy Trains and Tom Myers (www.anatomytrains.com)
Again, indicating when one is strong/tight, the other is weak/long.
Remember, the TFL is dominant over the GM, and the PL is dominant over the TA. Therefore, in terms of movement, we have a dominance of internal rotation of the femur, a dominance of lateral rotation of the tibia, and a dominance of pronation and plantarflexion of the foot.
This imbalance at the IT band will make itself evident during movements like a squat.
This is overwhelmingly the predominant cause of knee pain for people. And this is why so many people are trying to stretch their IT band.
However, now we can tell just “stretch the IT band” is a poor remedy. We need to stretch the band in a very specific manner in order to get rid of our knee pain.
The most effective stretch is going to calm down the overactive muscles and wake up the underactive ones. We need to loosen the tensor fascia latae and peroneus longs, but tighten up the gluteus maximus and tibialis anterior. An ideal stretch will combine:
-Hip adduction (loosen TFL)
-Lateral rotation of the femur (loosens TFL and tightens GM)
-Hip extension (loosen TFL and tighten GM)
-Internal rotation of the tibia (loosen TFL and PL, tighten GM and TA)
-As well as ankle dorisflexion and supination of the foot (loosen PL and tighten TA)
Why most IT band stretches fall short
Now that we know what makes an ideal IT band stretch to help get rid of knee pain, we can talk about why some stretches aren’t good. Let’s look at some of the most commonly used IT band stretches:
Breaking this down:
-We have lateral rotation of the femur (good)
-Possibly some internal rotation of the tibia (possibly good)
-Hip Abduction (Uh oh –This tightens the TFL)
-A great deal of hip flexion (Shit –also tightens the TFL and actually stretches the GM. Opposite of what we want.)
-Ankle plantarflexion and no pronation or supination (This isn’t good, but, you could modify this to make it better)
This is actually a fairly good stretch for the posterior aspect of the IT band. But as we’ve dissected at this point, we rarely want this. I’d say at least 95% of people with knee pain / people who need to loosen their IT band don’t want to stretch the posterior part.
Don’t forget about the abdominals
Before criticizing another stretch, this is a good place to talk about the abdominals, specifically the external obliques.
If we agree a tight TFL is a common issue in those with knee pain (if you don’t, you’re wrong), we need to also look at how a tight TFL affects the abdominals. I don’t want to go into another treatise on movement at the hip, but suffice to say much like the TFL and GM have opposing effects on the hip, so do the TFL and external obliques.
That is, the TFL pulls the front of the hip down and the EO pulls the front of the hip up (so do the glutes). In someone with a tight TFL, not only will they potentially have weak glutes, but they will have weak EO too. The result is a lordotic posture:
Therefore, a common effect of trying to stretch the TFL is an associated lordosis. This is because the TFL is tight and doesn’t like being stretched, it’s “stiffer” than the abdominals, so it pulls the hip downward to try and lessen the stretch. Not something we want when we’re trying to loosen that sucker up.
This is my long way of saying when attempting to stretch the TFL -and IT band subsequently- we need to pay careful attention to how the hips and lower back are moving. Ideally, they aren’t. Realistically, they do. This is often a pain in the ass to get people to do properly.
We’ll come back to this. Keep it in mind for now.
The next stretch:
Breaking it down:
-We do have hip extension this time (Much better than the other stretch)
-We have ankle plantarflexion (Not good. But this could be modified in the stretch. Although it still wouldn’t be ideal)
-We have hip adduction (Good)
-We have either a neutral tibia or lateral rotation of the tibia (not good)
-Femur is either in neutral or medial rotation (Not good)
At least this stretch is targeting the TFL portion of the IT band and not the GM portion. However, there are other issues. Referencing the importance of the external obliques, remember how we want the EO to be stiff when we stretch the TFL / IT band to make sure we’re generating as good of a stretch as we can and we’re not achieving movement from the lumbar spine.
You can’t see it in the video, but I guarantee the girl has a lower back arch during that stretch. Look around the internet of people doing this stretch and you find this rather quickly:
Notice the arched lower back? While the TFL / IT band is still being stretched some, we’re not doing anything to concurrently stiffen up the abdominals. Next, due to the lordosis, we’re generating a bit of stretch on the glutes. Finally, we’re also promoting mobility at the lumbar spine. Mobility at the lumbar spine is a precursor to lower back pain.
While you could cue the person to squeeze the abs to prevent the lower back arch, I find people have a really, really hard time with this. They just don’t know when they’re doing it properly, the right way it should feel, etc. It’s like coaching a 40 year old virgin.
Sorry, doctor, but you sir do not have the “world’s best IT band stretch.“
The better way
Breaking this down:
-By making sure the knee does not fall out to the side we have hip adduction (Good)
-A tiny bit of lateral rotation at the femur (Good). More can be accomplished but I find this doesn’t influence the stretch much.
-By letting the leg fall to the ground we let gravity give us hip extension (Good)
-Internal rotation of the tibia from turning the foot in (Good)
-Ankle dorisflexion and supination by pulling the big toe up and in (Good). If you do this last, you’ll notice a difference in the intensity of the stretch between letting your foot fall to the ground (plantarflexion) and pulling it up (dorisflexion). Many people will exclaim they get a better stretch all the way up in the hip just by pulling the foot upward. Further evidence the dorsiflexion and supination is helping to stretch the TFL / IT band and the TFL and TA are connected.
Also, because of the self-feedback mechanism of laying on a bench or table, you always know whether or not your lower back is arching (in lordosis). Therefore, you are guaranteed to know how hard you need to be squeezing your external obliques to make sure there is no compensatory movement at the spine.
Next, by lifting the arms overhead we can also generate a nice stretch in the lats, pecs, and rectus abdominus (all commonly tight). Not really necessary for a stretch aimed at knee pain, but it sure isn’t hurting anything.
BOOM. How’s that for bang for your buck?
With that said, here are the common ways people may mess this up:
1) Letting the foot plantarflex and pronate
You HAVE to make sure your foot is not pointing down and out to the side.
2) Not fully contracting the abdominals
If you’re not feeling any stretch in your hip / thigh it’s almost guaranteed you’re not fully squeezing the abs.
Watch the difference in thigh position when the abs are fully squeezed and when they are relaxed:
Notice the thigh elevates, bringing the hip into flexion, each time the EO are fully contracting. This illustrates tightness in the TFL because when the EO fully contract and posteriorly tilt the pelvis, the TFL is put on stretch. And when it’s put on stretch you can see the tightness by the thigh being pulled off the bench.
One sure fire way to know whether or not your abs are squeezed tight enough is if you’re lower back is flat on the bench. If it’s not, you’re abs aren’t tight enough. It’s worth noting for those with a fair amount of fat on their body, and or lower backs, sometimes they give themselves the “feel” of their lower back being flat when it isn’t. It’s just that their adipose tissue is thick enough to give them that illusion.
If you’re watching someone, it’s best to look at the top of their hips. Do they look angled downward? Like an anterior pelvic tilt? Then the abs aren’t squeezed enough. It’s hard to describe, but you can spot it.
If you’re having trouble with your abs (this is just a sign they’re weak and not strong enough yet) grab your opposite knee and pull it into your chest. This will allow your upper body to help posteriorly tilt your pelvis.
Then you can progress to one arm holding the knee in and the other arm overhead:
And then to both arms overhead.
3) Letting the hip abduct
This will happen due to the TFL not wanting to be stretched and thus pulling the hip into abduction.
For some people adducting the hip to a certain point will cause them to feel pain / pressure in their knee. This signifies that when the TFL is on stretch, knee pain arises. This is verrrry common.
Simply only let your hip adduct to the point where you don’t feel pain. Over time as the TFL loosens up you’ll be able to adduct further and further.
4) Poor posture at the upper body
A lot of people may not be ready to put their arms overhead when they first start doing this stretch. Many just do not have the thoracic mobility yet (or EO strength) to lay their upper back and head fully flat on the bench. Look at the difference in head posture here:
By making sure the chin is tucked you help insure the external obliques are posteriorly tilting the pelvis and not the rectus abominus. When you have that forward head posture and thoracic flexion the RA is in a shortened position. We do not want this. We want to stiffen up the EO, not the RA.
One final note: Don’t expect to feel an insane stretch when you do this. It’s not like you’ll feel like your TFL or thigh is going to rip apart from such a good stretch. Be much more concerned with doing it properly. Often times the biggest thing people feel is a hell of a lot of abdominal work. This is good. Remember, stiffening up the external obliques will indirectly loosen up the TFL.
Hold the stretch for at least 30 seconds.
And I’m out.
Please note the “best” element of this stretch is meant to be a sarcastic play. Understandably, sarcasm doesn’t always land through text. There’s no one magical exercise or stretch for every situation. See the comments for more.
For a more comprehensive look at stretching the IT band see: 6 Exercises to Loosen the IT Band
For a look at meshing this with a running program check out: 6 Weeks To A Healthy 10k
Here are some related posts I’ve written:
- Standing version of the best damn IT Band stretch
- My visit to the Washington University in St. Louis
- Sleep positioning and knee pain
Finally, if you’re tired of sifting through information yourself, get one on one help.
Peggy
July 13, 2013
not everyone follows this pattern.
reddyb
July 15, 2013
Very true.
betty
July 25, 2013
I am 77 and have both ITB and neurophathy caused by breaking the femur bone two times. Please give exercise for this age group. On walker now.
reddyb
July 26, 2013
Hey Betty,
Without seeing you and knowing more about you, I can’t really give you anything specific. There’s just too many factors.
Where are you located? I may know someone in your area who could help you.
Or, I do help people remotely. You can find out more about that here: http://b-reddy.org/2013/06/20/the-remote-client-process/
Chad
August 5, 2013
Hello ReddyB,
Great blog. I’ve just recently stumbled onto it trying research on my current knee pain. Maybe you can give me some insight into my current problem. Recently, while quickening my pace, I began developing knee problems. Left knee only. I’ve not seen someone about this yet; pain has been ongoing for about three weeks… My feeling is it will go away if given time to heel. The pain happens if sitting for long periods of time, going up stairs, and while running sub seven minute miles. Usually, slower pace doesn’t present too much a problem. The pain is not so unbearable that it debilitates, though I have a higher tolerance for pain than most. Physically, this is perhaps where you’ll be able to give some incite. Reading about common knee problems, of course, I soon came across a plethora of sites which mention weak quads, then deeper research got me interested in VMO… I was actually shocked to find, when comparing the two legs, an immediately noticeable difference in left and right VMO, left being smaller and clearly less defined. This is the hurt knee. What are some causes for this? I can tell you that I am pretty inflexible–have just started a daily stretching routine and will be incorporating the stretch above for IT; I’ve not noticed any swelling in the knee, despite pain. My typical mileage in a week for the past year has been from twenty five to forty miles. I quickened the pace and dropped mileage 25 per week, to under 35 min five mile workouts near daily to do other forms of cross training, adding weight and plyo. Single leg extension was possibly when I first noticed the pain in left knee. My feeling is that this has been a developing problem that is now rearing its head. What types of things can cause the unevenness in VMOs? I realize there could be several things and I’ve possibly given you very little to go by, but what are some of the more common reasons this could occur? Any insight would be fantastic!
reddyb
August 6, 2013
Chad,
Some notes on sitting and knee pain here: http://b-reddy.org/2013/01/27/cycling-clicking-sitting-and-knee-pain/
In many knee pain cases the muscles which pull the knee cap laterally, such as those connecting to the IT band, become too active. Conversely, muscles which pull the knee cap medially, the inner quad / VMO believed to be one (I’ve never looked extensively into this), become underactive. I talk about about how medial glide of the patella can be pain relieving here: http://b-reddy.org/2012/09/03/my-visit-to-the-washington-university-in-st-louis-physical-therapy-program/
Some places will tape the patella in a manner conducive to medial glide, which has been reported to be pain relieving. Taping is not a skill I have or attempted to learn though.
Don’t lose site of the principle: How you move is what often causes these things. It’s not “weak quads” are the cause, because what caused the quads to become weak? (Or whatever, you get the idea.)
A prominent other scenario is knee surgery / injuries. The quads are notorious for shutting down in these cases.
Hope that gives some insight.
tammy
October 9, 2013
I have been suffering Medial shin splints for 6 months. I live in the Chicago area.I am a 2:49 masters marathon runner that is desperate for help.
reddyb
October 10, 2013
Hey Tammy, I’m sorry but there are probably other places out there better suited for your needs.
Lacy Dickerson (@lacydickerson)
November 12, 2013
Thanks for the info! My knees have been giving me trouble since college and I’m running the Fit Foodie 5k in a few days down here in San Diego. I’ve been looking for the best way to stretch my IT Band and I think this could really help. I’ll try it out at the gym today!
reddyb
November 13, 2013
Hey Lacy,
Just FYI, I’m located in San Diego should you ever want an in person evaluation.
Best of luck with the 5k.
-Brian
Sid
November 13, 2013
Reddy, thanks for the article, I will be including this stretch from now on. What is your position on foam rolling the IT band? I ask because the IT band is not truly a muscle, as you state above and I have heard contradictory advice (isn’t there always?) It hurts like hell, so I would like to think it is doing some good! Thanks in advance. Sid.
reddyb
November 13, 2013
Hey Sid,
Long post on foam rolling here: http://b-reddy.org/2013/05/20/issues-with-foam-rolling/
Mark C
November 27, 2013
Hi there
I have been suffering with pain on my upper hip for about 4 months now. It started on my left hand side and after taking a few weeks off running and doing some glut strengthening exercises it appeared to just go away. Now after about 4 easy runs the pain has reappeared in my right hand side. It does not hurt during the run but gradually builds after the run and is especially sore the next day. The pain is directly on/below my iliac crest and particularly on the bony protrusion of my upper hip, I can bring pain to the area by standing on my right leg and pushing my buttocks towards the injured side but also by pressing on the area as if it were bruised. The first few steps after sitting down are quite sore too. I have seen three different PT’s, the first said it was due to calf and hamstring tightness (waste of money) the second and third said my gluts weren’t firing properly (my one leg squat is pretty bad as my right knee tends to veer inwards almost straight away) so I stuck rigidly to the glut strengthening programme they gave me but to no avail. After 4 weeks without running, some glut strengthening and dry needling I ran a slow 10km but alas the pain returned and I now find myself back to square one.
To give you some context I am a 29 year old male triathlete and cross train very regularly. The summer just gone, prior to the injury, I competed in 3 sprint triathlons and 3 sub 1:25 half marathons. The pain first flared after a grass interval session. Although I always stretched after each training session / race I will admit to not having a strength and conditioning programme built into my routine.
My PT now thinks that the pain might be caused by my ITB. Is this a common area for pain associated with your ITB? Could it explain why the pain has travelled from my left side to my right? I have never really suffered from knee pain beyond what I might fell as a little soreness following a particularly long cycle. My left leg is apparently about 1/2 cm longer than my right leg but the PT does not think this is relevant.
Thanks in advance for any comments / advice that you may have.
reddyb
December 1, 2013
Hey Mark,
In my experience, this is a less common place to have sensations. The TFL can become strained if other muscles aren’t doing their fair share. It sounds like you’re ADDucting that right leg too much and too often. This is what causes you pain. (Pushing your butt to the right side while standing not the right leg would put the leg into adduction.)
So, you want to stop putting that leg into adduction. You’re probably doing this while you’re running considering your propensity for the motion during something like a single leg squat.
You may find some use in this: http://b-reddy.org/2012/12/27/thoughts-on-correcting-a-lateral-pelvic-tilt/
I bring that post up because it’s not just the knee caving inward you need to look at, you need to look at the hips as well. For example, if the right hip hikes up that will tend to put the right femur into adduction, even if the femur didn’t actually move.
And yes, this does involve the glute medius BUT that doesn’t mean you go into a glute strengthening program. You need to go into a “Don’t let my leg adduct” program.
Lastly, and this can be a really tough part with running, doing a bunch of exercises aimed at this doesn’t mean you’re guaranteed a transference to running. If you’re having pain running you almost assuredly need to change how you run as well. (Don’t let your leg excessively adduct while you run.)
This can be tough to go over in a comment but hopefully that all makes sense.
John
November 28, 2013
Interesting stuff Reddy, you certainly seem to know far more than any physio I’ve been to (and there’s been a fair few). Hoping you might be able to spot what my problem is and suggest some corrective exercises/stretches
I sprained my right ankle twice in 18 months which lead to me having an arthroscopy. Prior to the surgery, if I tried to run or play football, I would get bad shin splints on the inside of the tibia on both legs and a horrible pain just below the knee which I think was/is patellar tendonitis/jumpers knee. Also developed quite noisy but not painful chondromalacia in my left knee (compensating for the weak right ankle/leg maybe). I think everything was due to the massive lack of range in my right ankle
So I’ve had the surgery and been trying to build my calf strength back up and work on flexibility. I’m getting there on both counts but the jumpers knee is even worse on the left side along with the chondromalacia (slight pain very rarely). I’ve got snapping hip on the right side too. I know my glutes and abs are weak due to sitting down most of the day. The IT band is very tender at the insertion point on the side of the knee (right and left) and if I try to do the traditional IT band stretch like this [redacted broken link] then I feel it most in the jumpers knee area.
If I stand on my right leg then my right hip wants to spin out (right hip forward, left hip back) and my knee/lower leg collapses inwards. I think this is what is happening when I run hence the shin splints.
So there is a fair bit going on and I can’t even run for 30 seconds without pain at the moment. I’d love to get back to being able to play football for 90 minutes but that seems a long way off at the moment. Is it as simple as strengthening the abs and glutes (which exercises work best?) and foam roll and stretch the IT band?
One other thing I have just noticed. If I balance on my left leg my hips/pelvis are neutral. If I balance on my right and then I go in to a fairly serious anterior pelvic tilt. So there is clearly an imbalance in either hip flexor tightness/glute strength/ab strength from one side to the other
Thanks, John
reddyb
December 2, 2013
Hey John,
You may want to check out my “6 exercises to loosen the IT band” resource. ( http://b-reddy.org/2013/08/20/6-exercises-to-loosen-the-it-band/ )
There’s quite a bit covered on the site and in all these comments too. Foam rolling, stretching, abs, glutes, etc.
I wouldn’t do the stretch you linked.
Harper
December 2, 2013
I stumbled across your site recently and was very thankful for the way you broke everything down when explaining the issues with IT band tightness and TFL overuse. I have been struggling with ITBS on my left side since this July (4 months). I competed at the collegiate level for 5 years and was basically injury free the entire time. I never experienced any problems with my IT band. I still run regularly, or atleast I did, but not as intensely. Right before my knee pain started, I had decided I wanted to give minimalist shoes a try. I gradually worked my way up using them, but apparently it wasn’t gradual enough. Or perhaps my body just does not agree with minimalist shoes. The onset of knee pain was not gradual but very intense and sudden. I should also note that I have been wearing motion control shoes and orthotics for the past 6 years without any problems. Since the knee pain started, I have rested, iced the knee, foam rolled my TFL like crazy, worked on gluteus max and gluteus med strength and nothing seems to be helping. I am still in the exact same spot I was 4 months ago. After reading your post, I plan to start trying the stretch you suggested but was wondering if you had any other suggestions as to what might be going on. One chronic problem that I do have is a tight left piriformis which I wrestled with all through college, but it is in no means painful, just really freaking annoying. I know that a tight piriformis can occur from having a weak gluteus medius and so have tried with lots of lateral band walks and clam shells to correct this. I also believe that my left femur is slightly internally rotated. You can tell when looking at the back of my legs. Any insight you have would be greatly appreciated! I am going crazy not being able to run! I should also mention that I have a degree in exercise science, not a PT by any means, but I do understand quite a bit about the way the body moves and works.
reddyb
December 4, 2013
Hey Harper,
I’d look around the site a bit. Quite a bit of what you brought up is addressed.
Foam rolling, internal rotation of the femurs, other exercises to loosen the IT band, and more. I link to many of these things in the comments of this post.
Den
January 16, 2014
This is an excellent discription and one that I have come back to a number of times.
Other stretches are just not as effective, and I like the explanation of why.
It’s kind of awkward to find somewhere to do this one, so I was doing the standing version for a while, I though correctly. I have very tight Hip Flexors, TFL, so tight I am can’t. Stand for more than 40mins, hamstring get very tense, pain in back etc. I have build up my Glues, hams, etc but still have a problem, so though I would do the original version, and it seems to stop my TFL from been tight straight away.
I am can barely get flat, in almost a U shape, on my back. I can’t lie flat and hold my knee. And to strech back is a hardcore abb work out, like cant hold for more than 4sec. But seems to work for 30 mins of so!!
So my question, how often should I do this to have a lasting impact? Do you suggest anything else?
Thanks for the advice.
reddyb
January 16, 2014
Hey Den,
I have an ebook with comprehensive answers for your questions here (only 12 bucks): http://b-reddy.org/2013/08/20/6-exercises-to-loosen-the-it-band/
Erin
February 15, 2014
Thank you for your informative post. I have been battling IT issues in my left leg for 3.5 years now. Like many, I have tried foam rolling, PT, steroid injections, orthotics, new shoes, yoga, strength training, and modifying my running form. In order to do the stretch correctly, should the glutes be engaged? When I try to bring the thigh down, extending the hip as much as possible my glutes engage but that raises my lower back. Am I pushing it too far too quickly? Also does a tight psoas often come with a tight TFL or is it just another sign of the weak abs and tight hips? Thank you for your time, I am sorry if these questions have already been addressed.
reddyb
February 17, 2014
Hey Erin,
Keep the glutes relaxed during this stretch. If you want a movement where the glutes get involved more, check this out: http://b-reddy.org/2012/06/01/standing-version-of-the-best-damn-it-band-stretch/
Going with the above, you shouldn’t be actively extending your hip during this. Let gravity do that for you.
A stiff (which isn’t the same as short) TFL is much more common than a stiff or short psoas. Feel free to search around the site. There is a lot written about the psoas.
Maggie
April 14, 2014
So, I’m sure this is my inexperience talking, but when I follow the “better way” video, I don’t feel a stretch where I expected (outside of thigh or outer/back of hip). All I feel is a slight burn in the inside of my legs (where the muscles are working to keeping the thigh from splaying outward) and of course the abs, and shin which is working to flex the foot. Should I be feeling a “stretch” somewhere? I’m just not sure this is doing anything…other than maybe strengthening some opposing muscle groups (like inner thigh) that might need it!
reddyb
April 16, 2014
Hey Maggie,
From the article:
And then from one of the comments above:
jfsabl
April 19, 2014
Thanks–This would explain 4+ months of soreness and tightness in strip down the side of my thigh (acute after skating or snow shoveling); hip pain (exact location); knee pain (ditto, but for years); a couple of months of wandering foot pain (in a girdle from the lower outside of the ankle, lower outside of the foot, and over the top of the foot), popping knees (new).
Also explains that “destabilized rotation” feeling when walking downstairs (has developed over ~2 years); extra-unstableness in squats and lunges; tightness in the front of the hip/lower abs while doing quad stretches; even the lower back issues / lordosis. Looking at the pix, I squat (and leg press, and walk downstairs, and perhaps even pedal) wrongly, pulling my knees in medially, for a sensation (illusion?) of stability. It also explains why more cycling and walking doesn’t seem to be helping, even though I’ve been trying to be mindful of better leg position / “not toeing out” (my previous problem). I’ve noticed that my legs are again flopping laterally at the knee when I lie on my back, and the knees are too far lateral when doing quad stretches, but (unlike in the past) the problem wasn’t lower back tightness, laterally. I had also noticed that the “front of my hips” (lower, lateral abs) were crazy tight, but didn’t make the connection, nor figure out how to reliably stretch them (because, yeah, compensatory lordosis).
I’ll be going to the gym shortly to try this stretch, paying attention to the details. No joke, this has been bad enough that I’ve been falling (including down the stairs a few times), and went as far as getting an MRI to see if the loss of stability (and resulting falls) and weakness and pains were some CNS problem. Assuming the stretch helps…can I paypal you something?
reddyb
April 21, 2014
Hey jfsabl,
Donations are always appreciated :). There is a paypal button on the right of the site. If you’re on a phone or tablet, I believe you have to scroll all the way down.
While this stretch could prove beneficial, you almost assuredly need more than just the one stretch. A good exercise program, focusing on how you move and strengthening things, would be a great start. If you’re truly that unstable, that’s going to require some work to correct and improve.
jfsabl
April 21, 2014
Paypal incoming shortly. Thanks again! They’re really a revelation, and giving relief.
I already swim with fins (dolphin and flutter, back and front), bike (in an upright position), walk, and do the occasional gym circuit. I am already moving mindfully about not toeing out or “kneeing out” like crazy (which I used to do). I just have to add mindfulness about lordosis–curl the pelvis forward, pack down those lower abs, pinch the glutes a bit. Swimming with fins is probably always going to tend to produce this problem, but I enjoy it, and I need it for my knees and because I dive. But I can watch my core position, and get more of the power stroke with the fins from the abs and quads, not (as now) primarily from my back muscles and secondarily from the tibialis itself. Use/strenthen the abs, quads and glutes while correctly aligned, and do these stretches. On the bike, I’m going to try a more road-bike position, which should discourage lordosis. And again, get more of the power from the quads (correct) not my back (yeah, I know that’s bad form). Ditto hiking up steep hills–when my legs are sore, I’ve been climbing by rocking my pelvis, again a lordotic sort of thing, alternating side to side. (Means I have to hop or jump, or turn and descend backwards, when going downhills, because I can’t do the equivalent rocking with my pelvis forward.) As for leg presses, I got sloppy with form because I was doing a modified version to mimic skiing–will knock that off, I can see where it would be counterproductive. Now that I feel what’s right, it’s pretty clear what’s been wrong.
When I’m in the right position, back touching the bench (well, the dining room table, actually), abs firm, joints and toes aligned, toes pulled up, I actually can’t even drop the calf more than a few degrees relative to the thigh, nor even get the thigh level with my body. My leg just sort of cantilevers out and up…but then it starts to ease down a little, and feels wonderful. With the standing version, my foot has to be really low, an inch or two under my knee height, to get all the other aspects right on–again, as soon as I pull the pelvis into place, it feels so great! Leg position has improved several degrees in just the first couple of days of stretching, and the sensation is totally “right.” It even seems to be loosening up my lower back (huge bonus).
Apologies for this much detail, but I figure someone else may find their way to this page based on their symptoms or their bad form in exercising, so I’m tossing it all in.
reddyb
April 22, 2014
Thank you very much for the paypal Joy. I appreciate it.
I think changing the leg press to non-skiing form is a smart idea. Skiing is one of those activities that is just hell on the lower body, particularly the knees.
As far as bike form, you seem like you are headed in the right direction, but I do have some videos and comments on biking here, if interested: http://b-reddy.org/2013/01/27/cycling-clicking-sitting-and-knee-pain/
(Also worth mentioning, I’ve noticed higher seats seem to help people too.)
What you’re saying regarding your stiffness in the supine stretch sounds exactly right. In terms of someone who could benefit from it, the stiffness you’re describing is spot on. That’s the type of stiffness you want to alleviate. As I mentioned, sounds like you’re heading down the right road. Keep it up!