Iliotibial Band Syndrome (ITB syndrome or IT Band syndrome)

With many people gearing up for running events later this year now is a great time to take a look at one of the common conditions that often rears its ugly head amongst the running community.

What is ITB syndrome?

ITB syndrome is an overuse syndrome which results in irritation and inflammation of the iliotibial band (IT band). ITB syndrome  often presents as a sharp pain on the lateral aspect of the knee (femoral epicondyle) however symptoms and discomfort can radiate the entire length of the illiotibial Band (IT band) continuing up to the hip region where it blends and attaches with the  muscles on the outside of the hip (gluteal fascia and tensor facia latae). It is also not uncommon to have pain referral into the proximal calf (gastrocnemius) however this symptom is not always present. The injury can also sometimes be felt by the presenting client during running (or other activities involving knee flexion such a cycling) as a flicking or clicking sensation in the lateral knee region. This is felt as the IT band flicks over the bony tubercle at the point where it passes over the knee.

What causes the condition?

ITB syndrome is an overuse or repetitive stress syndrome that typically occurs due to repetitive knee flexion and extension (like the action of running) and can also involve muscle weakness or imbalances and poor running biomechanics. Irritation to the IT band and subsequent inflammation of the band and surrounding area occurs due to excessive friction between the lateral femoral epicondyle and the iliotibial tract. This friction is caused during the eccentric loading phase of the gluteus maximus and tensor fascia latae (which occurs during leg deceleration) which results in tension being created along the IT band and causes the band to contact and rub on the lateral femoral epicondyle.

Prevention

  1. Regular body maintenance either through self-care or from an allied health practitioner can assist in injury prevention. Remedial massage techniques such as myofasical release (MFR) applied to the ITB region as well as release work to associated tight muscles such as the tensor facia latae can help to unbind and release the band from underlying structures. This helps to prevent the occurrence of ITB syndrome by relieving the tension in the IT band and reducing friction over the lateral femoral epicondyle during flexion and extension. A similar result can be achieved through foam rolling by rolling down the length of the IT band.
  2. Strengthen your lateral hip muscles (especially your gluteus medius) as these muscles provide stability and control during running and help to ensure proper muscle recruitment and biomechanics can be achieved. Exercises like side planks, banded crab walks, clams, single leg squats and side legs raises are all useful exercises in relation to strengthening these muscles.
  3. Structuring your running program to avoid excessive hill running (or incline running on a treadmill) will help to limit the chances of developing ITB syndrome. Running on an incline keeps the knee in a flexed position for a longer period of time and therefore places more strain on the IT band which can result is irritation and inflammation. Limiting the time your knee spends in this position will help to limit your chances of developing the syndrome.

If you have any questions or need some help in preparation for an event, please feel free to get in touch with me at Torquay Sports Medicine Centre!

Nathan Wilson – Remedial Massage Therapist

nathan@torquaysmc.com.au