Understanding and Managing ITB Syndrome
With the return of sports underway many of us are increasing our running volume. Although there are many benefits to running, a sudden increase in milage can result in pain on the outside of the knee. This is known as Iliotibial Band (ITB) Syndrome.
ITB Syndrome is the second most common injury amongst runners and the most common cause of lateral knee pain.
What is the Iliotibial Band (ITB)?
The ITB is a thick band of connective tissue on the outside of the thigh which runs from the upper portion of the thigh to just below the knee. It helps to stabilise your leg whilst running, walking, and standing on one leg.
What is ITB syndrome:
ITB syndrome is characterised by a sharp pain on the outside of the knee. It is an overuse injury, meaning it occurs due to a sudden increase in training load. The pain is usually worse when running, going downstairs or hills and after prolonged sitting with a bent knee.
The exact source of pain with ITB syndrome is thoroughly debated in studies, and multiple theories exist. Despite this, there have been various risk factors and treatment methods identified.
What can put you at risk of developing ITB syndrome?
It is important to identify any underlying factors that may be increasing your risk of injury.
A change in load e.g. increased distance, frequency or speed of running, weight gain, change in surface
Weak muscles on the outside of the hip
Frequent downhill running
A poor fitting bicycle seat
A low bodyweight
Narrow foot placement whilst running
What to do if you have ITB syndrome:
Modifying your training load can help to reduce the symptoms of ITB syndrome. This can be combined with manual therapy techniques to reduce pain and symptoms in short term to aid you in solving the problem long term. Physiotherapy can aid you in load management and manual therapy.
Physiotherapy Assessment may include:
Taking a thorough case history and special tests to rule out other causes of your pain
Biomechanical assessment of lower limb control in activities
Running assessment
Strength assessment
Palpation of your muscles and joints
Physiotherapy Management may include:
Soft tissue release of tight muscles/fascia
Taping to offload the knee joint and provide symptomatic relief
A targeted home exercise program to improve lower limb strength and reduce risk of re-injury
A return to running plan