How To Sensibly Relieve Iliotibial Band Pain; It’s All About The Trauma Reflex

I’ve written about Iliotibial Band pain syndrome before. In my previous iliotibial band pain post I explain what it is as well as how this condition is yet another example of Sensory Motor Amnesia. Here is an email I just sent to a woman who has my DVDs, has a personal Somatics practice, yet is stumped by her IT band pain:

Many people ask me if I have Somatics DVDs for specific body parts that are causing them pain. I tell everyone the same thing – which will be the focus of my upcoming second book:

It is never just one muscle causing the pain or problems in your body. It is always a pattern. The brain organizes you as a system in which patterns are primary. Address the dysfunctional muscular pattern and that body part will cease to be painful. In the case of iliotibial band pain, it is the Trauma Reflex.

An habituated Trauma Reflex causes iliotibial band pain.

Pain in your iliotibial band develops because your brain and muscles have habituated to human-body-muscle-diagramthe Trauma Reflex. One side of your leg (the IT band) is working harder than the other side. You may have already seen my iliotibial band release on my YouTube channel. You’ll notice that it’s a variation of the Side Bend – the most important and powerful movement one can do to regain control and awareness of the waist muscles.

When the waist muscles are tighter on one side than the other, those muscles “hitch” the pelvis up slightly on one side. What happens then? Your brain, the great compensator and integrator of all sensory and motor feedback in your life, teaches your legs to work differently, one side to the other. This happens, in most cases, completely under your conscious awareness.

If you have bilateral IT band pain, you may be stuck in the Startle Reflex (red light reflex). The Startle (red light) Reflex, a full body pattern, causes your knees to bend slightly  which makes it impossible for your pelvis and legs to swing freely.

Look at the full body pattern, learn to reverse that and your iliotibial band pain will go away. Use the mirror: what do you look like side to side? Are you uneven? Do you walk in an uneven gait? Do you put more weight on leg than the other? Consider what you do during the day that may cause that to happen.

Go back to the basic Somatic Exercises on your DVDs and start from the beginning. Look for balance, symmetry, quality of movement, and the ability to move the same on one side of your body and the other. Be mindful of patterns, especially when you get to the Side Bend, Washrag, Steeple Twist and Walking Exercises. Take your time! As you get to the walking exercises you have a great opportunity to even out the pelvis and the movement of the legs. And remember that nothing you do in your practice makes any difference if you don’t take that awareness and apply it to the way you move throughout your day – walking, sitting, holding a bag on your shoulder, working out, driving…

This is sensible information that needs repeating again and again and again. This woman is not alone in her frustration. After all, most people are not taught sensible information by our doctors, our physical therapists, our fitness trainers.  We aren’t taught that our brains are the source of the problem and that we are the only ones who can re-educate the way our brains and muscles communicate. We are taught to see ourselves as separately moving parts, like a car or bicycle, when in fact we are a beautifully balanced, synergistic process that can only be experience from within.

Once you can walk smoothly and evenly, squat right down through the center (use a mirror!), hitch your hips up side to side smoothly and evenly, you know your iliotibial band pain will be gone for good!


How To Know If You’re Out Of Balance

Daily stress teaches our muscles to contract in very specific ways. If the stress is on-going or repetitive enough we may even feel as if we’re “stuck” in our stress. Over time we may find that we feel “out of balance.”

An imbalance in the center of the body will show up as an uneven gait, twisted pelvis, slumped shoulder on one side, one-side muscle pain or quite commonly, a “hiked” hip. Overly contracted muscles pull us off balance and add excessive stress to our joints. They can contribute to arthritis, joint pain, back, iliotibial band pain, neck, shoulder and hip pain. The key is to learn to ride the waves of stress in our lives – not get stuck in them. Learning to find neutral in the center of the body and bring the brain back into control of the muscular system is one of the biggest benefits of Somatic Exercises. It is a skill not unlike any other skill needed to live in today’s world. In fact, it’s one of the most important skills necessary to become stress resilient.

In this video below you’ll learn an easy and quick way to determine if you’re out of balance. Don’t worry! If you are, you can begin to learn how to regain muscular balance and symmetry with Somatic Exercises.

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Foam Rollers: Do They Really Help Sore Hips, Glutes and Muscle Pain?

Are foam rollers really all that useful?

Many of my readers have asked me about foam rollers. What do I think about them? Can they really eliminate muscle pain that develops over time?

If you’re looking for more than temporary relief – no, they don’t. In fact, I would say that they might even invoke the stretch reflex, making your muscles tighter than they were before. Do they help move lymph through your body after a tough workout or run? Possibly. Do they teach your hips to move better and more fluidly so you don’t have hip pain, and in turn, knee and foot pain? Definitely not.

Tight muscles that you feel need to be “rolled” are often in a state of Sensory Motor Amnesia.

Sensory Motor Amnesia (SMA) is that condition of chronically contracted muscles that won’t “turn off.” These muscles have learned to stay tight due to accidents, injuries, surgeries, overtraining and stress. They are stuck in a constant feedback loop of contraction. No amount of foam rolling will reverse sensory motor amnesia.

The way you move is a reflection of what’s going on in your nervous system.

The point being: if you don’t address the nervous system and how it controls muscles and movement, you won’t create much improvement in your ability to relieve tight hips, gluts, iliotibial bands or the like after a workout, run or day at the office.

Sensory Motor Amnesia(SMA) is a reflection of one’s nervous system: SMA doesn’t really show up until there’s enough pain and restriction of movement that you finally take notice. It is the “canary in the mine shaft” in regards to muscle dysfunction. If you find that your hips are always tight, your gait is “off,” your pelvis is twisted or your leg length is uneven, your brain and nervous system has ceased to be able to coordinate your muscles properly. It has lost awareness.

How do you regain sensory awareness and relieve muscle pain?

Through opening up new pathways in your brain and doing movements you might not usually do (this applies to athletes every bit as much as the seated office worker) you teach the brain and muscles to move more intelligently. This is the key to not needing to use foam rollers, thera-canes or other gadgets to release muscles and improve flexibility. Granted, if you like to foam roll because it’s cheaper than a massage, I completely understand.

Muscles that you’re told need to be rolled after every workout (so they don’t develop adhesions) can be easily and rapidly released through the technique of pandiculation. Pandiculating muscles “wakes them up” at the brain level, reduces accumulated muscle tension in the muscle, and allows the brain to more accurately sense and therefore move the muscle. This kind of intentional “re-boot” of muscle function makes a whole lot of sense. Animals pandiculate – 42 times a day in some cases. This means that animals don’t get muscle strains and pulls because their nervous systems are always in constant control.

If your hips, quads, back or iliotibial band are always tight after a workout or run, I would suggest incorporating some “preventive” somatic education in your workout warm-up.

Tight hips? Remember: tight hips are caused by tight back, waist and abdominal muscles that don’t allow for movement in the pelvis when you walk. Read this, watch these videos, and watch this video.

Iliotibial band pain? Watch this video. Also learn these somatic exercises for the hips. Learning to release the hips and regaining a smooth gait is the key to being able to prevent iliotibial band pain.

Back pain? Try arch and flatten, arch and curl, the back lift and cross lateral arch and curl (from Pain Relief Through Movement).

Several blog posts ago I also gave suggestions regarding Somatics “warm-ups” and “cool downs” that can help improve one’s muscle function during their workout. Go back and review them. You’ll be glad you did.

Ed Barrera, Hanna Somatic Educator, soccer player and owner of GravityWerks in Washington state plays 5 soccer games a week and competes yearly in the US Veterans World Cup. He confesses to never having muscle soreness after games or competition – and never getting injured! Why? Somatic Exercises in the morning and evening and before every game. Read what he has to say here. 
Click here to buy my book, Move Without Pain, and my instructional pain relief DVDs.

How Somatics Can Help Cyclists Relieve Muscle Pain

Cycling is a universal activity – one that can be done casually as a form of transportation, or one that can be done competitively. Cycling, whether competitive or for pleasure, has the potential for serious injury, sensory motor amnesia and a host of painful muscular conditions. The most frequent problems facing cyclists are accidents, knee problems, iliotibial band pain, low back pain and hamstring strains.

In cycling there is a high risk of trauma.

When you lose your balance on a bike, the consequences can be long lasting, even if you’re not aware of it at the time. A crash off a bike instantly invokes – in the brain and muscles – the “trauma reflex,” the somatic reflex of contraction, and retraction of the trunk rotators of your body in response to a sudden loss of balance and the need to avoid further injury. The waist muscles contract unevenly on one side of the body, and the result is a slight twisting and side bending of the torso.  A cyclist who experiences sensory motor amnesia in the form of a trauma reflex will develop a pelvic imbalance, altered gait (or cadence on the bike), hip joint tightness, uneven weight distribution and a loss of balance.

Cyclists round forward in a hunched posture for long periods of time.

The rounded posture of cyclists is a useful pattern of muscular habituation that helps them do what they do as long as they do.  It is necessary for efficiency, power and speed. However, this rounded posture of cycling is  a classic “red light reflex:” the front of the body is contracted, the shoulders are tight and rounded forward and the back is lengthened, yet tight. 

There’s a “co-contraction” between the front and back of the body – an agreement of sorts – that makes this useful form of Sensory Motor Amnesia(SMA) great for cycling, but inconvenient and potentially painful for everyday life. The constant co-contraction of the abdominals and lower back can cause chronic lower back pain.

There is limited hip movement in cycling as leg movement comes from the hip joints.

The muscles of the quadriceps (thighs) are emphasized in cycling. They are recruited and developed more than the gluteal muscles. Because of the repetitive and powerful churning of the legs, there is little movement of the hips in cycling. As I wrote in my post on running, limited hip movement contributes to iliotibial band syndrome, back pain, hip joint pain and hamstring strains. SMA can occur in the hamstrings due to habituation; the legs are never fully lengthened, so the hamstrings learn to stay contracted in order to coordinate with the quadriceps. The knees bend, but the leg never fully extends. Both the quadriceps and hamstrings maintain a specific muscle length in order to “get the job done” well.

Shoulder hunching can become a habit if you’re not careful.

“Pleasure” cyclists are in a less stressful position because of the placement of the handlebars. Though they aren’t as hunched over as they would be were they on a racing bike, there is still a tendency to hunch the shoulders slightly to reach for the handlebars.
Lengthening the spine to keep the back muscles long as you hinge at the hips to sit up will ease back pain. Here is a good demonstration that illustrates how to elongate your spine as you ride on a bike with upright handlebars.

Try these Somatic Exercises as a warm-up before you ride:

After your ride, try these:

Click here to purchase my Pain Relief Through Movement DVD or any of my other “Pain-Free” instructional DVDs.

Contact Martha to find out how Hanna Somatics can complement and strengthen your current athletic training program.

How Somatics Can Help Runners

Running is one of the most convenient activities available for those who want to move vigorously. 

University of Utah biologist David Carrier hypothesized that our ability to run long distances evolved in humans for the simple reason that the ability to pursue predators for long distances (endurance hunting) meant a steady food supply. We were born to run, but for some people, running is a painful and laborious activity.

As with any sport – and especially one that can be taken to an extreme, runners suffer from injuries and sensory motor amnesia. The most frequent running injuries are knee pain, iliotibial band syndrome,  plantarfasciitis and hip pain.

Running when injured creates more injury.

Many runners will often continue to run, even when they are nursing an old injury. Some of the runners I’ve worked with say that they figured they could just “run it out” thereby fixing the problem. Unfortunately this causes more harm than good. Here’s why:

  • When you’re injured, your muscles reflexively adapt and learn to move differently. This is called compensation.
  • Long term compensation develops into sensory motor amnesia (SMA).
  • Running while compensating for an injury doesn’t doesn’t change what your muscles are doing; it only creates more compensation.
  • You must first eliminate the compensatory pattern (the SMA), and then you can regain your original running form.

Runners often run on uneven, paved roads.

A majority of runners in cities and suburbs run on uneven asphalt roads. The road is slightly graded to allow for water runoff, so rather than using the legs and hips equally, they run with a slight tilt in the hips, with  more weight on one leg than the other. This causes the waist muscles on the higher side of the graded road to contract tighter than the other side. It’s slight, but when this kind of sensory motor amnesia develops it alters the gait and contributes to iliotibial band pain and knee pain. The angle of the road also put the foot an an awkward angle to the ankle.

Runners often have limited hip movement.

When hip and pelvis movement is limited, you will be more likely to have iliotibial band syndrome, back pain, hip joint pain and hamstring strains. A pelvis that doesn’t rotate gently doesn’t allow the body to move gracefully and efficiently. If the body is stiff and the hips and pelvis rigid, the swinging action of the legs while running (or walking) will come solely from the hip joint – what I like to call “running with your legs instead of your whole body.” This can create overuse injuries of the hips and hamstrings. Here’s a ChiRunning article that goes more into depth about pelvic rotation.

Orthotics and “supportive” running shoes reduces the foot’s ability to move.

The feet are one of the most important sensory organs of the body. When we encase our feet in  shoes we risk losing sensory awareness and motor control of the muscles of the foot and lower leg that help us stabilize ourselves for upright movement. There is more of a tendency to “heel strike” when wearing thicker running shoes. This is both jarring for the spine and inefficient for forward motion.

Orthotics, thought to fix foot problems, interfere in the ability of the feet to absorb impact properly and adjust to changes in terrain (as in trail running). Thankfully there’s a trend toward more minimalistic and “barefoot” running shoes, which allows both the foot and lower leg muscles to move naturally.

Here are 5 somatic exercises for an easy “warm up” before running:

  • back lift – for control of the back muscles
  • cross lateral arch and curl – for control of the abdominal muscles
  • side bend – to equalize waist muscle function
  • steeple twist – for gentle twisting of the shoulders, spine and hips
  • walking exercises – for proper mechanics of walking and pelvis rotation

After your run, try these:

Click here to purchase my Pain Relief Through Movement DVD or any of my other “Pain-Free” instructional DVDs.

Martha is available for specialty workshops and clinical teaching in the US and overseas. Contact her for more information.

Many thanks to Jim Hansen, a runner and Somatics enthusiast whose shared running experience helped me write this post. Check out his blog here.

Why Iliotibial Band Stretches Don’t Work, and What Does

Iliotibial Band Syndrome is a common problem with runners and cyclists and those who have suffered an injury.

The iliotibital band, commonly known as the “IT band,” is a band of tissue extending from the hip, along the outside of the thigh and knee.  With “Iliotibial Band Syndrome” the IT band becomes very tight and sore, making it difficult to exercise.

How does the iliotibial band syndrome occur and what can you do about it?

Iliotibial band syndrome occurs when the IT band becomes inflammed during repetitive flexion and extension of the leg in running, biking and hiking (this is a very simplistic explanation). I would offer another perspective – because not all runners, cyclists and hikers suffer from a tight iliotibial band and/or accompanying knee pain.

Iliotibial band syndrome is the result of a “trauma reflex.”

The most common muscular pattern I see in people with iliotibial band pain is the “trauma reflex.” The photo at right is of a recent client – a soccer player – who complained of right sided iliotibial band pain, hamstring and knee pain. It is a perfect example of the trauma reflex. Notice the following:

  • the waist muscles on the left side of his body are tighter, hiking the left hip up higher than the right.
  • his left shoulder is pulled down in response to the tightening of the waist muscles.
  • the shift in his pelvis causes him to shift his weight to his right side.

When this occurs, the pelvis is pulled out of balance and twists slightly. This can occur if you’re a runner who slips in the mud, or a cyclist who falls off his bike, or as you slip down the stairs. This “trauma reflex” alters the gait in such a way that one will run or walk as if he were a car with one flat tire. This kind of accumulated muscle tension on one side causes the IT band to tighten in order to stabilize the relationship between the pelvis, hip and knee. In this client’s case, we did a clinical session for the trauma reflex, and in one hour, his hamstring, knee and IT band pain disappeared once he learned to even out his waist muscles and regain symmetry in his pelvis.

One common treatment is stretching out the IT band.  The trouble is that it doesn’t work. Here is why:

Stretching fascia that is attached to to muscles that are constantly contracting suggests a lack of understanding about how the muscular system works. Fascia is tight because the muscles are tight. Muscles become tight through habituation – in the case of IT band pain – a trauma reflex, which creates a postural imbalance. Because muscles are controlled from within – both voluntarily and involuntarily fascia will become more pliable once the muscles relax. Fascial work is an example of attempting to fix the problem from the “outside in” when in fact, it can only be fixed from the inside out – through sensory motor retraining. Learn to change the way in which you sense and move your muscles you are on road the targeting the root cause of your pain: your brain.

Try this easy pandiculation for the iliotibial band pain relief:

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