Iliotibial Band Syndrome is a common sports injury whereby pain is felt on the outside of your knee joint, especially when running downhill or going downstairs.
It is a non-traumatic overuse injury and is often experienced alongside weak hip abductor muscles (gluteus medius).
The ITB is a thick band of fascia that runs from the hip to the outside of the knee. Overuse is thought to be caused by the repetitive bending and straightening of the knee causing compression and friction of the iliotibial band as it inserts at the knee. This causes pain and inflammation around this area. This is known as Iliotibial Band Syndrome, or ITBS for short.
What causes ITBS?
– Activities that involve repetitive bending and straightening of the knee (as seen in running and cycling), leading to an overload eventually.
– Sudden increase in level of activity.
– Running on slightly banked ground, as the subtle drop of the outside of the foot stretches the ITB and can increase the risk of injury.
-Weak or fatigued gluteal muscles. If these muscles are weak or fatigued, they are unable to control and tension the ITB effectively and so it starts to rub in a less controlled manner over the protruberance near your knee on the outside. The weakness of the gluteal muscles also caused the hip to fall into internal rotation and the knee to adduct (track medially), causing biomechanical issues at the knee and sometimes even at the ankle/foot.
– A full biomechanical assessment needs to take place to assess exactly what the contributing factors are to enable a swift recovery back to your preferred activity.
Signs and symptoms of ITBS
– Burning pain on the outside of the knee.
– This can be a sharp pain especially when the heel strikes the floor that can radiate into the outer thigh and even the outer part of the calf muscle.
– Pain is usually worse when running especially running downhill or going downstairs.
– Pain may get worse with longer distances.
– Occasionally there may be an audible snapping feeling as the knee bends and straightens.
– Swelling may be present around the outside of the knee.
How do I heal my IT Band?
It is vital to address the underlying biomechanical issues for optimal and quicker recovery. A full assessment of the hip, knee, ankle and foot needs to take place to determine what the issues are.
The initial treatment is to manage the load that the ITB is under.
This may mean that you need to adapt your running initially until it settles down. This may include only running flat routes, halve your normal distance, reduce the speed etc.
If your body tolerates the adjusted load well, you can gradually increase the load. A general rule of thumb is to increase either speed or distance by 10% a week. Do not increase both of these together as the load will be too great and you will find the injury lingering longer than is necessary.
Usually a good gluteal strengthening programme is vital to the recovery of ITBS Injuries. Your physio will guide you as to which exercises are appropriate according to your healing stage.
Footwear and arch support may be required.