How To Reverse Iliotibial Band Pain: Addressing the Trauma Reflex

I’ve written about Iliotibial Band Syndrome (ITBS) 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 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 the 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. One of the biggest benefits of Hanna Somatic Exercises is learning to find neutral in the center of the body and bring the brain back into control of the muscular system. 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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Why Is One Leg Shorter Than The Other? The Trauma Reflex!

Here are three frequent questions my clients ask me:

Why do I have one leg shorter than the other?

Why do I have hip pain, knee or foot pain but only on one side?

I’m told that my pelvis is rotated because I have a weak core. Is that true?

The answer:

Leg length discrepancy, one side hip, knee, and foot pain, sciatica, tilted posture, piriformis syndrome, and a rotated pelvic are all the result of an habituated Trauma Reflex. No, the core is not necessarily “weak.” It is likely so strong and tight – within the pattern of the Trauma Reflex – that the center of the body cannot fully relax, rotate and side bend evenly on both sides.

When you respond to any physical trauma, a sudden blow to the body, a slip, fall or accident of any kind, the brain instantly, involuntarily, and often violently, contracts the muscles of the waist (the oblique muscles), the trunk rotators (lattisimus dorsii, abdominals, adductors and abductors of the legs) and the muscles that allow the pelvis to swing freely (quadratus lumborum and iliopsoas) in an attempt to avoid injury or to prevent further pain after the accident has occurred. If you’ve ever prevented what could have been a terrible fall you know the wrenching pain that comes with the sudden twisting movement that helps you regain  your balance.

If the accident is severe or violent – a car accident or a sudden slip on the ice, for example – the brain teaches these muscles to stay tight and contracted. If you injure yourself on one side of your body and need to protect that injured limb until it is healed (as occurs when using crutches), you can inadvertently learn to walk with a limp once the injury is healed. A one-sided job, like sitting at a computer and using the mouse all day with one hand can create a strong imbalance on one side of the body.

When muscles stay tight the brain loses the ability to fully contract and release the muscle. The ability to fully release the muscle is what gives the muscle power. This state of elevated muscle tonus and tension that won’t relax is called Sensory Motor Amnesia. In the case of an habituated Trauma Reflex your brain integrates and organizes this learned and involuntary full-body imbalance into a “neutral” and “balanced” that, as those of you have ever suffered an accident or injury, can sense is out of balance, tilted, rotated and uncomfortable. Not to mention inefficient.

How do you learn to regain symmetry and balance in the center of your body? Muscles that have learned to stay tight and contracted due to stress must learn to relax, release, and move freely again. It’s muscle reeducation. Many people can benefit from one-on-one clinical sessions with a qualified Somatic Educator skilled in the methods of Thomas Hanna. However, many people can also easily learn to do this on their own, at home.

The video below can help you learn to lengthen both sides of the waist evenly so you can regain your internal awareness (“somatic” awareness) and proprioception for improved balance and a smoother gait. This easy awareness exercise is best done after you learn to relax and release the waist muscles by doing arch and flatten, the side bend and the washrag.

To learn more Hanna Somatic Exercises and learn to relieve muscle pain and improve mobility, and somatic awareness, you can purchase my Pain-Free series of DVDs. Enjoy the video and enjoy standing tall!

Why Am I Limping, and Is It Cause For Concern?

Many clients have posture that is “out of balance”; their hips and pelvis are not level, their leg length is uneven, their gait is not smooth. Some clients have said, “Just the other day someone asked me why I was limping, and I never even noticed I limped… all I know is that my back is killing me!”

They’re not concerned about their limp, because their limp feels “normal.” This feeling of “out of balance” feeling “balanced” is an example of Sensory Motor Amnesia, in which the brain literally forgets how to sense, move and control muscles efficiently. We compensate, habituate and adapt to what happens to us in life (accidents/injuries are common) so our muscles no longer move freely the way they once did. When you lose awareness of the way in which you move – something that only you can experience – there is cause for concern.

Most of my clients with back, hip or piriformis pain often accompanied by a limp were treated unsuccessfully by physical therapy, bodywork of all kinds, drugs, and cortisone shots. What was missing in their treatment was the simple understanding of how a limp develops as a compensatory, full body pattern, which muscles are involved in the need to limp, and how to reverse the pattern and move freely again. Back, hip joint, knee pain, sciatica and piriformis syndrome pain are common conditions easily reversed with Hanna Somatics.

Limping means the center of your body is out of balance.

When we walk we are meant to walk with a smooth, even gait. Our pelvis is perfectly designed for upright, bipedal locomotion. The more we allow the pelvis to move as we walk, the more efficient and effortless our movement will be and the less joint stress and pain we will have. Below is a great video of balanced, strong walking and upright posture – a necessity for African women carrying items on their heads.

This kind of natural movement is “the norm” until something occurs to change that.

When we have an accident – a slip on the ice, a fall on our coccyx, or a bone break – the involuntary part of our brain immediately contracts certain muscles of the trunk to protect that area. This is called the Trauma Reflex. We learn to compensate until the injury is healed. The latissimus, obliques, adductors, abductors and abdominal muscles all contract instantly, in a pattern, as we twist and rotate in an attempt to regain our balance or protect our injured limb – as in the photo at right.

This kind of functional problem of one side of the waist and trunk tighter than the other can, over time, create true structural damage, like hip joint pain, labral tears, osteoarthritis, and hip joint impingement.

The Trauma Reflex causes us to limp, putting more weight into one side of the body.

When you get stuck in this particular stress reflex, pain isn’t far behind. You begin to walk like a car with one flat tire, galumphing from side to side. The easiest way to reverse a limp is to get the brain back in control of the muscles. Those who have had an accident or injury would be wise to seek the clinical help of a skilled guidance of a Certified Hanna (Clinical) Somatic Educator for a series of clinical sessions in order to restore full muscle function and movement.

Somatic Exercises for limping

For those who own my Pain Relief Through Movement DVD, the following exercises focus on the waist muscles/trunk rotators, and are excellent for helping to restore a free and balanced gait:

• Side bend – releases and lengthens the waist muscles for equal movement of the pelvis.
• Washrag – brings in gentle twisting of the pelvis, and shoulders, as the waist lengthens
• Human X* – the quintessential movement of “crawling,” which lengthens both sides of the body
• Steeple twist* – increases the ability to twist and lengthen the center of the body – back, abdominals, waist
• Walking exercises, part 1 & 2* – freeing the pelvis and reintegrating a healthy pattern of walking.
• Hip lift and reach – from my Pain-Free Leg and Hip Joints DVD

* found on the Pain Relief Through Movement DVD

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

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, 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 that 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 the 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, glutes, iliotibial bands or the like after a workout, run or day at the office.

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.

Muscles that you’re told need to be rolled after every workout so that 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 movement 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. Check out these Somatic Exercises for the hips. You may also be interested in my Leg & Hips Joints DVD.

Iliotibial band pain? Watch this video. 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 provided suggestions regarding Somatics “warm-ups” and “cool-downs” that can help improve one’s muscle function during a 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 never has muscle soreness after games or competition – and never gets injured! His daily routine of Somatic Exercises in the morning and evening and before every game are the secret to his pain-free life.

How Somatics Can Help Cyclists Relieve Muscle Pain

Cycling is a versatile activity – one that can be done casually as a form of transportation, a weekend hobby, or one that can be done competitively. Cycling, whether for competition 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. A bike crash instantly invokes 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 (SMA) 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 compromised balance.

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

The rounded posture of cyclists is a pattern of muscular habituation that is useful 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 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.

In cycling, the muscles of the quadriceps (thighs) 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.

Cyclists using bikes with upright handlebars are in a less stressful position because of the placement of the handlebars. Though they don’t hunch over as much as using a standard road bike, there is still a tendency to hunch the shoulders slightly when reaching 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:

• Arch and flatten
• Arch and curl with cactus arms (to release the upper chest and shoulders – from Pain-Free Neck & Shoulders)
• Side bend or washrag (to lengthen the waist muscles and regain pelvic balance)
• Hip lift and reach (to release the hips and across the front of the body – from Pain-Free Leg & Hip Joints)

Try these Somatic Exercises to cool down afterward:

• Back lift (to release the back muscles – from Pain Relief Through Movement)
• cross lateral arch and curl (to lengthen the back muscles on the diagonal)
• Flower (to release the muscles of the front of the body from the “red light” reflex)
• steeple twist or washrag (from Pain Relief Through Movement)
• Hamstrings and quadriceps pandiculations (from Pain-Free Athletes)

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 (SMA). The most frequent running injuries are knee pain, iliotibial band syndrome,  plantar fasciitis 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) before 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 are 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:

1. Back lift – for control of the back muscles
2. Cross lateral arch and curl – for control of the abdominal muscles
3. Side bend – to equalize waist muscle function
4. Steeple twist – for gentle twisting of the shoulders, spine and hips
5. Walking exercises – for proper mechanics of walking and pelvis rotation

After your run, try these:

1. Reach to the Top Shelf – for full body lengthening
2. Hamstring pandiculations – if you need it (from Pain-Free Athletes)
3. Standing calf release – if you need it (from Pain-Free Athletes)

Visit the Essential Somatics® store to purchase the Pain-Free Athletes DVD and more!

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

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 Iliotibial Band Syndrome (ITBS) occur and what can you do about it?

ITBS occurs when the IT band becomes inflammed during repetitive flexion and extension of the leg in running, biking and hiking. I would offer another perspective, because not all runners, cyclists and hikers suffer from a tight IT band and/or accompanying knee pain.

ITBS is actually the result of a Trauma Reflex

The most common muscular pattern I see in people with IT 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. 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.

Why doesn’t stretching help?

Stretching fascia that is attached 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 IT band pain relief:

Visit the Essential Somatics® store to learn to relieve your muscle pain in the comfort of your own home.