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Iliotibial Band Syndrome

Iliotibial band syndrome

Iliotibial band syndrome causes pain on the outside of the knee which is caused by friction of the iliotibial band on the side of the knee. It is also known as ITB syndrome or ITBFS and sometimes referred to as runners knee.


Symptoms of ITB syndrome consist of pain on the outside of the knee, more specifically at or around the lateral epicondyle of the femur or bony bit on the outside of the knee. It comes on at a certain time into a run and gradually gets worse until often the runner has to stop. After a period of rest the pain may go only to return when running starts again. The pain is normally aggravated by running, particularly downhill.

Pain may be felt when bending and straightening the knee which may be made worse by pressing in at the side of the knee over the sore part. There might be tightness in the iliotibial band which runs down the outside of the thigh. A therapist or trainer may use Ober's test to assess this. Weakness in hip abduction or moving the leg out sideways is another common sign. Tender trigger points in the gluteal muscles or buttocks area may also be present.


Certain factors may make you more susceptible to developing runners knee or iliotibial band syndrome. A naturally tight or wide IT band may make someone more susceptible to this injury. Weak hip muscles, particularly the gluteus medius  are also thought to be a significant factor.

Over pronation or poor foot biomechanics may increase the risk of injury. If the foot rolls in or flattens, the lower leg rotates and so does the knee increasing the chance of friction on the band. Other factors include leg length difference, running on hills or on cambered roads.


What can the athlete do?

Rest and apply cold therapy or ice to reduce any inflammation. Ice should be applied for 10 to 15 minutes every hour until initial pain has gone. When pain has gone and training starts again avoid downhill running. Iliotibial band stretches after training and throughout the day are important.

Foam roller exercises can help stretch the iliotibial band and remove any tight knots or lumps in the tendon. Self massage techniques can also be very helpful in correcting excessive ITB tightness.

What can the professional do?

A professional therapist may perform massage to help relax and loosen the tissues and use myofascial release techniques which have been shown to be highly effective.

A doctor may prescribe anti-inflammatory medication such as NSAID’s e.g. Ibuprofen. Dry-needling techniques or acupuncture may be beneficial also. Use of electrotherapeutic treatment techniques such as TENS or ultrasound may help reduce pain and inflammation.

A rehabilitation strategy which includes stretches and exercises to strengthen the hip abductors is important. In acute or prolonged cases a corticosteroid injection into the site of irritation may provide pain relief.

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