Iliotibial Band Syndrome

What is Iliotibial Band Syndrome?
Iliotibial Band Syndrome (ITBS) is thought to be one of the most common overuse running injuries affecting the lower limb – affecting 7-14% of the running population. Overuse is thought to be caused by repetitive knee flexion and extension observed in runners and cyclists. This repetitive motion causes friction in between lateral structures in the knee on the ‘heel strike’ and ‘stance phase’ of the running gait cycle. During this period of the gait cycle, the leg decelerates through eccentric contraction of lateral hip muscles, which generates tension in the ITB.

Common symptoms of ITBS include a sharp pain in the lateral aspect of the knee with activity, that may radiate into the lateral thigh or calf – this pain worsens with activities such as running or walking down stairs. There may be an audible ‘snapping’ sensation when the knee bends due to the ITB flicking over a bony tubercle. Abnormal kinetics of the lower extremity, and muscle weakness specifically in the hip abductors and changes/ increase in training have been suggested as predisposing factors to ITBS. A link has also been found between landing with less knee flexion on initial contact with the ground whilst running.

What can we do about it?
Activity modification to prevent further aggravation of symptoms should be the first area addressed. Relative rest will help the inflammation around the ITB to settle down – ice and anti-inflammatories may also help with this. Mild inflammation may settle in 2-3 days, however more severe may require weeks. The gluteus medius muscle is often the culprit in terms of muscle weakness, therefore a progressive rehabilitation programme focusing on gluteus medius strengthening, as well as gluteus maximus and quadriceps strengthening should be implemented. However the challenge is to strengthen without aggravating the ITB. Stretching and foam rolling areas of muscle tightness such as hip flexors, ITB and TFL (a muscle in the lateral hip) can also be used to relieve pain.

About Chapman Physiotherapy

At Chapman Physiotherapy Ltd we pride ourselves on offering a first class physiotherapy service in South Yorkshire. Based in Doncaster, our easily accessible location provides full disabled facilities and appointments are available from early morning to late evening.