• Nicki Llewellyn

Iliotibial Band Syndrome (ITB/Runners Knee Syndrome)

Iliotibial Band Syndrome (ITB)

ITB Syndrome is a prevalent repetitive strain injury amongst the sporting/hobbyist community. The main cause is due to a ligament that runs down the lateral (outside) portion of each of the legs becoming irritated and inflamed. The band is made up of a thick fibrous material that is dense and rigid. When musculature that act upon and control the band become imbalanced there is a tendency for the distal (lower) portion of the band to become inflamed, causing pain from mild irritation to severe and debilitating.

The main cause of ITB syndrome is without a doubt repetitive strain. Running being the most suspect activity that gives us this pain in the leg. There are other contributing factors we need to consider however and cannot solely blame an activity that we take for granted.

Other important factors that can cause or contribute to symptoms are -

· Worn out or unsuitable footwear

· Running downhill or on banked surfaces frequently

· Increasing mileage to quickly when training for longer distances

· Running track workouts or

What are the symptoms of ITB syndrome?

Predominantly pain, redness and swelling around the lateral (outside) of the knee. Often it’s mistaken for a knee joint injury however it’s not the case.

How do I tell if I have ITB syndrome?

Head to your local Sports Therapist, Osteopath or visit us at Body Solve. It is one of the things we deal with every day in the clinic. Bending your leg to around a 45 degree angle will most likely give you pain in the outer lower edge of the knee. If you do experience pain in that region during or after running then it is possible that you could have a problem with your iliotibial band.

A scan can help diagnose whether or not it is Iliotibial band syndrome however the treatment plan will still be very similar if there is another issue at the knee and so a scan can sometimes be a bit of a double edged sword. X-Rays or often not very good at diagnosing a problem here. An MRI will be far better placed to identify thickening and any inflammation of the band.

So what the hell causes this ITB syndrome?

There are many causes that can create this problem, the most notorious of all is increasing mileage far too quickly and without resting and the correct footwear. Other common causes are poor strength or misfiring of the Vastus Medialis (VMO - one of the quadriceps muscles located on the inside of your thigh). A misfiring VMO will cause mal tracking of the patellar and ultimately lead to poor biomechanics of the knee. This in turn will cause force to be distributed unevenly and lead to a host of issues one of which can be ITB Syndrome. Ultimately the main cause is the rubbing of the distal portion of the Iliotibial band against the bursa/bone that lies underneath which leads to inflammation, pain and swelling.

What to do if you get symptoms similar to ITB syndrome

1. First stop is that all familiar phrase ‘RICE’ (REST ICE COMPRESS ELEVATE)

2. Secondly seek professional help be it your local Sports therapist/osteopath or us at Body Solve

3. Take a look at the situation you were in when you experienced the issue first. For example were you wearing poor or worn out footwear, possibly a new pair of trainers that aren’t suitable for your foot mechanics? Have you been increasing the duration or distance of your sport or hobby? For example usually running 5k and now training for a half marathon.

4. Take on board what your therapist says and make every effort to do the exercises and stretches he or she gives you.

5. Don’t go back into your sport or hobby guns blazing, take it a lot slower, reduce the distance and slowly build it up over time.

6. Warm up thoroughly

7. Incorporate a strict mobility routine into your weekly plan. Whether it’s yoga, animalistic style movements, basic stretching etc.

8. Avoid running on harder surfaces (track, concrete and road). Head for the local playing fields or beach. Even trail running will not only be more varied but also a lot more fun than your regular loop or there and back routine.

9. Gait analysis – If you’re still having trouble after all of this then it would be advisable to see a sports podiatrist or a foot bio mechanics specialist to see if there’s something else going wrong.

Treatment of IT Band Syndrome

Once you notice ITB pain, the best way to get rid of it for good is to rest immediately. That means fewer miles, or no running at all. In the majority of runners, resting immediately will prevent pain from returning. If you don’t give yourself a break from running, ITBS can become chronic.

Look for an alternative training source. Swimming is a great all-rounder that gives the whole body a great work out whilst having little or no impact on the joints and musculature. This means that even when injured some light swimming exercise can be highly beneficial as it gets the blood pumping, the ‘endolphins’ (endorphins – the happy hormone) released and increases your immune system levels which will then decrease the recovery time.

See a sports therapist, they will likely assess your posture, analyse your walking/movement pattern, do a lot of soft tissue work releasing the musculature and reducing tension and improving muscle quality, mobilise the ITB as much as possible during the session (bearing in mind it is a thick fibrous tendon like structure that has little or no movement).

The sports therapists at Body Solve will likely do a lot of stretching with you and then teach you how to help yourself at home with exercises and stretching you can perform in the house or at your local gym.

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