Stretching the Truth – The Internet and Running Injuries

The internet is fascinating, isn’t it? You can find information on just about everything you want and go forward with that new found knowledge. Here’s the catch: what you read on the internet is unfiltered. Verifying the accuracy of what you read is tedious, particularly when the language (e.g. medical terms) you are reading is unfamiliar.

Take running injuries as an example. Iliotibial band syndrome (ITBS) is the subject of this article, but in the following paragraphs, feels free to substitute any number of running injuries and you will find the same misinformation out there.

A quick internet search finds the e-medicine website telling people that treatment for ITBS should focus on putting “proper stretching techniques into the patient’s exercise routine. These exercises concentrate on increasing flexibility of the ITB and of the gluteus muscles.WebMD also backs up that claim by stating that ITBS is treated with “stretching exercises” Unfortunately, neither website had any reference cited for those statements. Many other websites made the same claim for treatment. Unfortunately, there are no studies that show that stretching helps.

However, research identifying biomechanical risk factors for ITBS have been showing that ITBS is much more common in runners who’s hip and pelvic muscles are not properly stabilizing the hips/pelvis which causes abnormal movement at the knee. [1, 2, 3] So if the research is showing that it’s a problem with running biomechanics caused by instability, please tell me why we are going to introduce stretching into the problem? Essentially, this is taking a stability problem, using a mobility solution (i.e stretching), and making it more unstable.

Moving on with the stretching idea, here’s a thought: can we actually stretch the iliotibial band? A recent study [4] looked at that question and found the answer is pretty much “no”. After inserting strain gauges into the iliotibial bands of cadavers and stretching the iliotibial band and also using ultrasound to evaluate the amount of stretch in an iliotibial band on professional (living) athletes, the researchers found that the band is so thick and stiff, it was only able to stretch 2mm (0.5%).

I have merely touched on this topic. I never got into the bad advice on the web about the idea that foot and ankle overpronation can be the cause of ITBS and that orthotics will help. I didn’t get into the false ideas on the web that ITBS is because the iliotibial band is caused from a forward and backward displacement of the band which creates “friction.”

The point of this article is to be wary of what you read and who you turn to for advice. Are you consulting someone who understands anatomy and biomechanics and up to date on research?

All that can be said for sure was made clear in a systematic review of the literature and published in a recent journal [5]:

“The kinetics and kinematics of the hip, knee and/or ankle/foot appear to be considerably different in runners with ITBS to those without.” the journal article went on to say “While the articles were inconsistent regarding the treatment of ITBS, hip/knee coordination and running style appear to be key factors in the treatment of ITBS.”

In other words, studies are inconsistent on how to treat ITBS when it’s a problem, however, running style and coordination of the hips and knees are key factors in the development of ITBS. So now we know that the way we run is the cause. By examining the way we run, we can prevent it.

If you don’t know what to look for and how to correct it, you may be bound to be injured over and over again.

Running Reform looks at individuals and their running form. Running Reform uses a live, 45 minute internet based video/desktop sharing platform so that the runner has a full understanding of their biomechanical faults and how to fix them.