Patient comes in a with pain on the outside of their knee. They tell you that they consulted Dr. Google and found out that it is "IT Band Syndrome" and they have been following Dr. Googles advice and have been resting, using a foam roll and bought a brace over the last month.  They state that it starts feeling good then as soon as they run again they are in pain. You run them through a functional screen, you might even use the FMS. You notice that when they squat their knee drops inward and they round their back.

So what is going on here?  I like to describe this as a Victim and Culprit scenario.  The patient has pain on the outside of the knee.  Is the problem the outside of the knee, the Culprit?  In this instance I would say NO.  The Culprit is the weakness that is allowing the knee to fall inward.  The ITB and knee is just the Victim.  We can do all the consoling to the ITB (icing, resting, foam rolling...) but this won't fix the problem.  We must address the Culprit.

Another analogy I like to use is that of two factory workers.  We have two guys working on the line.  As the widgets come down the line one guy is doing his job.  He is taking the widgets off of the line and putting them into boxes.  The other guy is a bit slower than the first guy and he takes a lot of coffee breaks and he is constantly running to the bathroom.  So because the line never slows down the first guy (the knee) has to pick up the slack of the second guy (the hip muscles).  This happens one day, no big deal.  Then it starts happening everyday and maybe weeks and months go on.  The first guy doesn't say anything about it.  Then finally he is feed up.  He starts complaining to the boss (the brain).   This is what is happening in the ITB scenario.  So in this in case are you going to just console the first guy or are you going to address the real problem and talk to the second guy about his work ethic and fix the problem?

This is a very common thing we see with treating the musculoskeletal system.  Rarely is the source of the pain the Culprit.  It is commonly another site that is the true problem.

We must fix the problem if we want to truly have resolution of the problem.