Are you getting pain on the outside of your knee? Particularly after long runs? If so, you could well be suffering from IT Band Syndrome. Your running technique may be contributing to this problem. In this article we are going to discuss a common running technique error that could be causing your IT Band Syndrome. Then we’ll talk about how to fix it.
What is IT Band Syndrome?
The IT Band (aka iliotibial band) is a band of connective tissue that runs down the side of your thigh from your hip and inserts into the side of the knee. It provides some lateral stability to the knee and it originates from the Gluteus Maximus and the TFL (tensor fascia latae) near the pelvis.
As we land when running we bend the knee a little to help cushion the impact and give a spring to push off against. When this happens the IT Band moves from being in front of a bony outcrop known as the lateral epicondyle of the knee to behind it. This causes some stress but it is a normal part of life for an IT Band. However, sometimes the IT Band is doing that too often. If it can’t adapt to the stress it becomes irritated and painful and that’s what we call IT Band Syndrome.
There is a certain type of running technique error that causes more stress in the IT Band where it attaches to the knee, it’s called a Crossover Gait.
What is a Crossover Gait?
A crossover gait is when our legs literally cross over each other as we run. If we are looking at someone from behind we can see them land the left foot and then when the right foot lands it is further to the left. The right foot crossed over the midline before landing. We can see an example of a crossover gait in the video below.
A crossover gait is an extreme example of a narrow step width. Imagine viewing someone running on a treadmill from behind. If they had a very wide step width their feet would strike the ground far apart as if they were running on train tracks. Someone with a more narrow step width would be striking the ground as if they were running on a tightrope. Someone with an even narrower step width would be crossing the midline before striking the ground – i.e. running with a crossover gait.
Is a Crossover Gait Bad for Runners with IT Band Syndrome?
In 2012, researchers recruited 15 healthy runners and analysed stress and strain in the IT Band at different step widths. They analysed preferred, wide and narrow step width and found that as the stress and strain within the IT Band increased, the more narrow the step width became. They concluded “Increasing step width during running, especially in persons whose running style is characterized by a narrow step width, may be beneficial in the treatment and prevention of running-related ITB syndrome.” (Meardon 2012).
A possible explanation for the increase in IT Band stress when running with a more narrow step width may be the fact that the more narrow step width increased knee abduction (think butterfly movement by a hockey goalie). This knee abduction seems to be associated with increased peak forces in the knee (Brindle 2014).
What should I do about it?
Well, that’s a good question. I have not been able to find any evidence to show that runners with a narrow or even a crossover gait pattern are more likely to develop IT Band Syndrome. So if you have never had this problem, I wouldn’t go messing around with your step width. However, if you currently have IT Band problems, or you have had recurring problems in the past, increasing your step width may reduce the load on your IT Band and that may reduce your symptoms.
There is also an argument to intervene from a performance standpoint. Energy spent zig-zagging your legs across each other is energy that you could be using to propel you forward. So if you are looking to improve your running economy, some very careful work on your step width may be in order. I would only recommend doing this under the supervision of a trained professional (shameless plug for our Free Running Technique Assessment).
Increasing Your Step WIdth
If you do have trouble with your IT Band, you can start by taking a video of yourself from behind while running on a treadmill. Draw an imaginary line for the ‘tracks’ where your feet are landing. In the next step we are going to widen those tracks. (You can also use the Hudl App as I have done in the video above if you want to be a little more precise about this.)
Now we are going to try a couple of cues and take a video doing each. First off, try thinking about “running on train tracks, not a tightrope”. Take a video and see what you think. Another cue to try is “create some air between your legs”. Take another video and see what you think.
In my experience, people tend to ‘over-correct’ with these cues and it can feel really weird. When this happens I tell people to do the same thing but only 50%. That usually reduces the ‘over-correction’ and makes the technique modification more comfortable.
If one of the cues feels good and you can see a wider step width on your video then try integrating this into your running technique. I usually recommend only 1 minute out of every 5 minutes on easy runs to start with. Then you can slowly increase to 2 minutes, then 3 etc. It should take weeks/months to transition, so don’t rush it.
If you would like a little help, feel free to send your videos in and I’ll have a look.