The iliotibial band or ITB is a thick band of connective tissue that runs down the side of your leg and attaches into the side of your knee. ITB syndrome or ITB friction syndrome as it is also known, is an overuse injury commonly seen in runners or with sudden increases hiking up and down hills on holiday.
What Is It?
ITB syndrome is a result of overload of the distal end of the ITB on the outside of the knee. While it has traditionally been described as excessive friction or rubbing of the ITB on the bone on the outside of the knee, recent evidence tends to suggest the issue is more a result of compression of the ITB attachment onto the bone.
While the severity of the condition will vary, common symptoms include;
- Sharp or burning pain just above the outer part of the knee.
- Pain that worsens with running or other repetitive activities such as walking, climbing, or going down stairs.
- Pain with bending the knee.
- Tightness and pain at the front or side of the hip
What Causes ITB Syndrome?
Pain in the distal ITB is a result of excessive compression of the tissue on the underlying bone due to poor control of the hip and knee while under load. A common feature seen is excessive medial movement of the knee under load either because of poor biomechanics, weakness of the muscles of the hip and thigh or both. Commonly this occurs with ramping up training loads too quickly or with a sudden spike in load.
Initial management involves firstly bringing training loads down to a level that the tissue is coping better with and managing inflammation and irritation of the tissue. This may be combined with stretching and rolling to decrease tension in the effected tissue.
Your physiotherapist will assess your biomechanics and strength, as well as help to create a picture of what is leading to the overload on the ITB, so they can help you learn to manage your increase in load and activity as pain decreases.
If you have been suffering from the pain of ITB syndrome, book an appointment today with one of our expert physiotherapists to get a plan to get you back to running or the sport you love!