Setbacks are the perfect opportunity to grow
Iliotibial band syndrome is most commonly experienced with runners. But also in all sports that require repetitive knee flexion under high load. Early signs and symptoms often go unnoticed (or ignored) until it’s blown up into a fully-fledged injury.
What is the Iliotibial Band?
The Iliotibial Band (ITB) is a thick fibrous band of strong connective tissue running down the lateral side of the thigh. Its attachment points at the hip are from the Glutes at the back and Tensor Fascia Latae at the front. The bottom connection feeds into the outer border of the knee and patella. It’s at this attachment point that pain and inflammation develops and would be classed as Iliotibial Band Syndrome (ITBS).
The role of the ITB is to provide the knee with stability and to abduct the hip outwards. When we walk, run or squat it’s working hard to keep the knee in the correct position and force is distributed evenly.
What are the symptoms of ITBS?
Problems arise when the lower limb moves in abnormal directions repeatedly, causing the band to flick over bony structures of the knee, leading to irritation. It may also get tighter than normal through shortening or over activity of the Glutes and Tensor Fascia Latae. This results in the ITB becoming a tighter band pulling more at its attachment and compressing other tissue around it.
ITBS usually is a sharp pain or burning sensation in the lateral knee. Generally, felt during exercise when the knee flexes repeatedly through mid-range. This range of 30-40 degrees is when pressure of the ITB against the bone is at its highest. If this movement is repeated enough, it causes friction and irritates the tissue.
What causes ITBS?
There are a number of factors that can cause a stir up of ITBS. Physically there could be a muscle imbalance, with tightness or weakness around the pelvis, hip or knee, reduced balance, and reduced ground reaction time. Mechanically, often due to the physical limitations that cause incorrect movement patterns, poor weight transferring and distribution of load.
On top of this are issues with training error. How quickly a programme is progressed, especially if it involves load or speed. From running to weight lifting, training loads need to be gradually increased to reduce the risk of injury.
Management of ITBS
Initially you may be restricted from doing the activity that caused your pain while your body recovers. An assessment will help you identify what factors are triggering your ITBS. Treatment will be multifaceted providing advice for tissue loading, gait retraining and specific muscle strengthening and stretches. Additionally, soft tissue manipulation, strapping and dry needling.
With the improved running form, increased strength and flexibility you will gradually be introduced back into the activity. This will make you overall better at your sport and reduce the risk of this problem returning.
Evidence shows that ITBS responds well to conservative management with a success rate as high as 92%.
If you’re struggling with recovering on your own contact me on 09 5290990