Breaking Body Myths: "Stretching the ITB"

Further application of the Alexander Technique has brought on a few new revelations this week as I have carried principles over to walking.

The history behind this change goes back to my freshman year of high school, when I hit my first real challenge to my physical fitness – one which to date I have not really been able to recover from.

I was practicing serves and saves with a volleyball against the bleachers before gym class – at one point my ankle rolled (which is pretty typical for a guy my height even in 9th grade I was already 6’ 3” and weighed around 210 lbs).

What was different this time was that my knee dislocated trying to recover the fall.

After several months of recovery time (no tears or damage as far at they could see, but a lateral dislocation to the anterior of the leg that was pretty severe) I always felt a bit shaky on that knee, but tried resuming regular sports activities when I could.

Then when I was a junior and counseling at our local church camp, I tried to reach for an outside pitch and the twisting motion I put into the bat dislocated it again – this time we were quite far from an emergency room. Thankfully there was a doctor resident who was able to help me get it back in – but it never quite felt the same.

After the second recovery, my participation in sports declined rapidly. I started gaining a lot of weight. I had heard of how many people twist or dislocate their knees while skiing, etc. A lot of activities became forbidden to me on account of my injury – and fear of injury. As my weight increased I felt less strong and my confidence in participating in athletics waned.

In college I tried various levels of weight training, but could not run well. Then for a few months after I graduated, I tried running again for a few months on a soft track… I decided that the pain I felt in my knees was just part of the process and that I had to ‘run through it’ as some of my long distance running friends often would do.

That didn’t last more than about 3 months.

Then in seminary – another 6 years later – I started training again. In the interim I had joined a gym and gotten some training advice for about 6 months. That was helpful for strength and weight ‘change’ (I can’t say loss because I gained more muscle than what I lost in fat I think) but my aerobic abilities were limited to non-impact – the elliptic was my buddy.

I began making considerable headway at seminary, doing roughly an hour total nearly every day. I started with 45 on elliptical, 15 on treadmill – slowly hoping that over time I would be able to do full treadmill and then attack Jamaica Pond full on (with good shoes, of course).

That’s when I got the snap. Running on the treadmill, my right knee gave this awful snapping sensation, just to the right of my kneecap. It got to the point where sitting down I could recreate the snap by massaging the side of my leg. Something was definitely wrong.

Once I had a job and benefits, I decided to have the whole situation looked at. Was my knee improperly relocated? Were there tears that healed improperly? What was going on?

The x-rays and MRI were conclusive. I had a few spurs from damage, but my cartilage was heavily eroded. The reason? My kneecaps are being pulled to the anterior side of my leg. Instead of riding the groove of my knee joint down the center line as they should, my kneecaps (both of them) grind to the outside edge of the joint.

This causes grinding sounds when I walk up stairs. What causes this? “I’m going to send you to physical therapy.”

I went for several months to physical therapy, where they were goiong to try to stretch out the ilio-tibial band (ITB) which goes from the base of your lower back and hip all the way down to (big surprise) the outside edge of the patela (kneecap). The ‘snapping’ sound/sensation was caused by the band rubbing across the knobby edge of the leg bone in the joint.

So we did stretches and leg strengthening exercises, massage and ultrasound. We did the roller – everything we could to stretch that baby out. It worked, to a point, but we were not able to make enough headway to get things aligned properly.

I was going to have to go back to the doctor. I would likely need surgery to solve the problem.

So that was where things sat. Along came Alexander Technique.

In an effort to stand prone – using the minimal level of muscles and work with gravity instead of against it, I found myself using a set of muscles I had not used before.

Letting my upper torso float on the bouyant support of my knees and hips, knees slightly bent and engaged, hips engaged slightly as well, I was doing something very different from my typical straight leg, back supported stance.

Instead of feeling the weight of my upper body being supported by my tightened lower back and my lower body in my heels, I now felt my full body weight in the soles of my feet with minimal weight being kept afloat by my knees and hips – which were slightly engaged (not fully at rest).

At first this was interesting, then slightly tiring, but in comparison to what I was putting my back through, this was nothing.

Well these ‘sea legs’ now have enabled me to walk in moving vehicles without losing my balance. You’d think this would be good enough news, but the best was yet to come.

These muscles, apparently, were what were too weak before – in other words, the tug of war for my kneecaps was persistently being won by my ITB when pitted against the leg muscles that run across the upper thigh down to the interior of my leg. I had not engaged this particular muscle set before on a regular basis prior to Alexander Technique.

So a few days ago I had a breakthrough. I was sitting in the bathroom after a shower and I felt this sensation in my right knee that I was accustomed to feeling after working out. I had been standing a long time the day before, and had begun doing full squats in the mornings during the week. If you have ever wanted to ‘pop’ your thumb or fingers – well imagine feeling that in your entire knee. Well I flexed those interior muscles – and POP! – I felt a deep joint pop that shook my entire leg. The odd feeling in my knee was gone! I’d had this feeling in my knee since my second dislocation. As I am sitting here right now and feeling the knee, where I used to feel something a little different… the knee now feels completely normal.

My conclusion? Yes it was true that the ITB on that side had shortened due to the stress of injury, but even after working that through it is tight for a reason! If you have been doing ITB stretches in an effort to balance your knees properly and avoid surgery, consider how you stand prone. If you are not using these interior leg muscles when you stand, it may be establishing a negative imbalance in your knees.

I don’t stand a lot, except on Sundays in church, and believe me, an hour of standing prone (especially in dress shoes) is more of a workout than you would expect if you have spent your life standing straight legged and putting all that weight on your heels and back.

However the benefits of engaging these muscles on a regular basis through integrated standing may just save you from knee injuries further down the road. Plus you gain a much stronger sense of balance when walking – even in moving vehicles.

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