Dry Needling vs IT Band Syndrome (ITBS)
Dry Needling vs. IT Band Syndrome in Runners
Jennifer Favinger
Doctor of Physical Therapy
Are you a runner struggling with IT band syndrome (ITBS)? Let me guess, you’ve heard all the common suggestions like: “just use a foam roller,” or “alternate which side of the road you run on.” While these suggestions aren’t necessarily bad, you need better tools in your toolbox if you’re truly going to beat this.
So what are we really talking about here? Iliotibial band syndrome, more commonly known as “IT band syndrome”, is a common impairment in runners often characterized by a sharp, burning sensation on the outside of the knee. The culprit? Friction between the iliotibial band, a thick band of fascia running down the outside of the thigh, and the underlying bony prominence of the tibia at the knee joint. In fact, this is precisely how the iliotibial band gets its name. It originates at the ilium of the pelvis, and then runs down the lateral thigh inserting onto the lateral aspect of the tibia at the base of the knee; thus the name: ilio-tibial band. This friction within the fascial band leads to microtearing, inflammation, and pain, which can then be exacerbated by running. Thankfully, runners suffering from iliotibial band syndrome have a powerful tool in their recovery arsenal if they choose to utilize it: dry needling.
Dry needling involves inserting thin, sterile needles into specific trigger points in the muscles and fascia. These trigger points are small, hypersensitive areas that can contribute to pain referral and muscle dysfunction. By targeting these trigger points, dry needling can effectively alleviate pain, improve muscle function, and promote overall healing in the affected area.
So you’re telling me that dry needling can get rid of my IT band syndrome? Where do I sign up?
Well, not entirely, but it’s a great place to start! The truth is, most cases of iliotibial band syndrome are a result of underlying movement dysfunction and compensatory muscle imbalances. It’s vitally important to determine and address the underlying root cause of your condition and subsequent pain. While the iliotibial band may be the painful structure, it’s often going to be dysfunction at the hip or even the ankle and foot that’s causing this additional stress and inflammation of the fascia. The structures of the body are tightly intertwined and dependent on each other. So if all you’re treating is the iliotibial band itself, you’re going to be missing a big part of the equation. While dry needling can do a great job of reducing pain and tension, its effects are going to be short-lived if you’re not also addressing the cause of the pain, leaving you frustrated and itching to get back into your running shoes.
As a former collegiate track and field athlete, I understand the rigorous demands placed on a runner’s body. I also understand the competitive drive that keeps us going even when we’re in pain. It can be difficult to take a step back from your training, but don’t let pain dictate your performance and keep you from reaching your goals. You owe it to yourself to get to the bottom of the problem. No amount of “rest days” will do you any good if you’re not also addressing the underlying cause of your pain. Whether you’re a competitive runner, or just enjoy it recreationally, a qualified physical therapist can get you back on track.
So, keeping in mind that further evaluation is needed to determine the cause of your pain, let’s take a deeper dive into exploring how dry needling can help you make functional improvements in your running today! Several research studies have explored the effectiveness of dry needling for iliotibial band syndrome with promising results.
A study from the Galen Medical Journal in 2021 compared the effectiveness of dry needling and shockwave therapy for the management of iliotibial band syndrome. While the researchers didn’t find a significant difference between the two interventions, they did find that both interventions, including dry needling, provided significant improvements in pain and overall functional performance compared to the control group.
Perhaps an even more compelling source of evidence for the use of dry needling comes from a systematic review published in 2022 by the International Journal of Advanced Health Science and Technology evaluating the effectiveness of physical therapy approaches for the treatment of iliotibial band syndrome. This comprehensive review analyzed eight previously conducted studies on the use of multiple physical therapy interventions, including dry needling, for the treatment of iliotibial band syndrome. While the evidence review suggested that a multifactorial approach is best, the researchers ultimately concluded that dry needling was in fact an effective and safe intervention for reducing pain and improving tissue tension in these individuals. Whereas treatments like friction massage alone did not have long term benefits
Additionally, the International Journal of Sports Physical Therapy published a case study in 2016 outlining the use of dry needling for a subject with chronic lateral hp and thigh pain suspected to be associated with iliotibial band syndrome. After just a few weeks of dry needling treatment combined with an overall strengthening program, the individual experienced significant reductions in pain and improved hip mobility, ultimately allowing them to return to their desired level of activity. While it’s common for people to primarily experience pain at the lateral knee when dealing with iliotibial band syndrome, it’s important to remember that this band of tissue extends from the knee to the hip so pain symptoms can refer anywhere along this path.
These studies, along with many others, provide compelling evidence for the effectiveness of dry needling in alleviating the symptoms associated with iliotibial band syndrome. Here’s a look into how dry needling can specifically benefit runners:
- Pain relief: Dry needling directly targets trigger points, which can be a major source of pain in iliotibial band syndrome. By reducing the activity of these trigger points, dry needling can provide immediate and significant pain relief. Additionally, dry needling performed in conjunction with electrical stimulation will help the body reprogram the neurologic pathways causing the sensation of pain in the first place. If we can beat the pain, we can get on the road to meaningful recovery and performance gain that much quicker. Which is ultimately the goal, right?
- Improved muscle function: Dry needling can help to improve muscle function by reducing muscle tightness and spasms associated with injury and dysfunction. This will then lead to improved running efficiency and performance.
- Increased range of motion: Iliotibilal band syndrome can often lead to decreased range of motion in the hip and knee due to the associated pain and tissue tension. Dry needling can help to restore normal ranges of motion and overall movement, making running more comfortable and enjoyable.
- Faster recovery: Dry needling combined with electrical stimulation can promote healing by increasing blood flow and reducing inflammation in the affected area. This can help runners recover from injuries associated with the iliotibial band faster and return to running sooner. If the pain is removed, we have a window of opportunity to address faulty movement patterns and compensations much more efficiently.
But remember, even in the face of all of this evidence supporting dry needling for the management of iliotibial band syndrome, it’s important to have a trained professional on your team that can systematically analyze your movement patterns to form an accurate diagnosis of the underlying cause of your pain. As mentioned previously in the article, it may have nothing to do with the iliotibial band at all! This tissue is just taking the beating, while other parts of your musculoskeletal system are not performing optimally. If we can reduce the stress within the system as a whole, we can eliminate the pain being caused by that stress. Don’t settle for a cookie cutter approach when you can have a plan tailored to your specific needs.
Dry needling is a safe and well-tolerated treatment with a low risk of side effects. When performed by a qualified and trained physical therapist, dry needling is a highly effective treatment for iliotibial band syndrome. It’s also an intervention that takes very little time to complete, so it can easily be combined with other interventions within your therapy session to include manual therapy, strengthening, and neuromuscular re-education to address the underlying cause of your pain and restore functional movement patterns. Faster pain relief while also improving your overall performance? That’s a win-win!
So, are you a runner struggling with iliotibial band pain? If so, dry needling may be the missing piece in your recovery journey, and we encourage you to reach out to determine if this treatment is right for you. With its evidence-based effectiveness and practical advantages, dry needling can help you get back to running pain-free and enjoying the sport you love. So, what are you waiting for?
We look forward to hearing from you!
Jennifer Favinger
References:
- Dimitriadou, S., et al. (2022). Effect of physical therapy approaches for the treatment of iliotibial band syndrome: A systematic review. International Journal of Advanced Health Science and Technology. 2(5), 346-354.
- Maghroori, R., et al. (2021). Shockwave Therapy Versus Dry Needling for the Management of Iliotibial Band Syndrome: A Randomized Clinical Trial. Galen Medical Journal, 10, e2174-e274.
- Pavkovich, R. (2016). The use of dry needling for a subject with chronic lateral hip and thigh pain: A case report. The International Journal of Sports Physical Therapy. 10(2), 246-255.