Do you feel pain on the outside of your knee when you descend stairs or run downhill? You may have Iliotibial Band syndrome. Also known as ITB syndrome, or IT Band syndrome, this is a frustratingly painful overuse condition which sidelines many runners and cyclists. The IT band is a structure that basically connects your hip to your knee and lower leg. It’s not a muscle, it’s not a tendon, but it’s a piece of connective tissue (fascia) that functions more like duct tape than like a rubber band. Muscles have elastic properties, meaning that they can lengthen, and then become restored to their original length. Connective tissue has less of these elastic properties, and can only lengthen a small amount before recoiling. The IT band also does not benefit from the same amount of circulation as a muscle, leaving it prone to injury, and difficult to repair.
Luckily, if we understand the anatomy of the area, and the physiology and histology of the tissues, we can formulate an effective treatment plan. Let’s first look at the anatomy of the ITB in relation to the hip, knee, and lower leg.
The IT band originates from a muscle called the tensor fasciae latae, and has two attachments, both to Gerdy’s tubercle on the tibia (shin bone) and to the head of the fibula (lateral shin bone). It’s function is to extend, abduct, and laterally rotate the thigh. It also is active in stabilizing the knee during flexion and extension, so it easily follows that if running and cycling involved repeated motions of flexion and extension, the IT band could become irritated, inflamed, or injured.
Pic: wiki cc
Symptoms of Iliotibial band syndrome:
-Knee pain when descending stairs
-Downhill running is painful
-Snapping sensation along knee or hip
-Tightness along the outside of thigh
-Pain that improves with rest
-Knee pain that develops after several miles of running
Causes of IT band syndrome:
-Weak hip or glute muscles
-Adhesions in hip or glute muscles
-Weak VMO muscle
-Too much/too soon
-Running on a banked surface
-Poor running form or improper shoe selection
-Uneven pelvis or short leg
Treatment of Iliotibial band syndrome:
-Rehabilitate weak hip, quad, and glute muscles
-Cross train while slowly increase mileage
-Correct running form through coaching or video analysis
-Check pelvis for misalignment or fixation, adjustments as needed
-Reduce adhesion in involved muscles using Active Release Techniques
If you are suffering from knee or hip pain, please give us a call at (510) 465-2342. We can help you determine whether you have Iliotibial band syndrome, and get you going in the right direction towards healing and get you back to running!
J Anat. 2006 March; 208(3): 309–316. doi: 10.1111/j.1469-7580.2006.00531.x PMCID: PMC2100245
The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome
John Fairclough,1 Koji Hayashi,2 Hechmi Toumi,2 Kathleen Lyons,3 Graeme Bydder,4 Nicola Phillips,5 Thomas M Best,6 and Mike Benjamin2 Sports Med. 2005;35(5):451-9.
Iliotibial band syndrome in runners: innovations in treatment. Fredericson M, Wolf C.