IT Band Syndrome

Iliotibial Band Syndrome (ITBS) is one of the most common injuries amongst runners plus many cyclists and hikers.  It is responsible for about one in twenty lower limb injuries in long distance runners and roughly one in twenty five people engaged in any kind of vigorous physical activity will get a form of it.

What is the Iliotibial band (ITB)?- The ITB is a connective tissue structure with some properties of a tendon, others of a ligament.  It runs down the outside of the thigh from a couple of hip muscles (Tensor Fascia Latae and Glute Max) to one of the lower leg bones (tibia) and the lower outside portion of the thigh bone (femoral condyle).

Common Symptoms

Sharp or burning pain just above the outer part of the knee

Pain that worsens with continuation of running or repetitive activities

Swelling over outside of the knee

Gradual onset of symptoms

Pain during early knee bending

These symptoms can be severe enough to side-line a runner for weeks or even longer.

What causes ITBS?

When the IT band isn’t working properly, movement of the knee becomes painful. The conventional wisdom says that it is a form of tendinitis, or at least an irritated tendon.  If this tendon (the ITB) gets too tight, it rubs painfully over a bump of bone on the side of the knee, the lateral epicondyle.  Recent research (Fairclough) has cast some doubts on this explanation and that the irritated structure is probably not the IT band and nor is the IT band too tight.  If the irritated structure isn’t the ITB then what is it – “Likely something under the IT band” is the simple yet frustrating answer.

While ITBS appears to be a simple condition, obviously caused by excessive knee usage and usually treated by resting.  But to those that don’t make a full recovery by simply resting it is equally obvious that there is more to it than that

Essentially ITBS is caused by altered running biomechanics due to underlying muscular imbalances.  Your biomechanics can alter due to a muscle imbalance (weakness or tightness), fatigue and ground impact issues.

Most common causes include-

Sudden increase in mileage in training

Excessive hill training (particularly downhill)

Endurance Running

Unsuitable trainers (including worn out)

Poor foot arch control

Weak Hip rotators

Weak hip/gluteal muscles

Weak inner Quadriceps

ITB Syndrome treatment

Avoid or reduce aggravating activity (short term) to reduce acute pain and inflammation.

Gait/biomechanical analysis to if required correct running and landing technique and function.

Soft tissue massage.

Specific targeted strength exercises (corrective exercises) to strengthen knee, hip and leg muscles.

Normalise lower limb muscle lengths through targeted stretching.

Self -Myofascial Release using foam roller.

Modify exercise regime to prevent recurrence.

If you would like treatment for this condition or any other please get in touch and book an appointment.  If you have any questions please feel free to e-mail on the contact page.

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