Author: Emma Mason
If you are a runner or a cyclist and you’re experiencing pain on the outside of your knee, it’s possible that its Iliotibial band (ITB) syndrome. This article will explain just what ITB syndrome is and what you can do to manage it.
Anatomy
ITB Syndrome is an overuse injury of the connective tissue called the Iliotibial band which runs along the outside of the thigh from the hip to the knee, connecting the tensor fascia latae and gluteus maximus muscles from the hip to the bones around the knee. The syndrome presents with pain on the outside of the knee and will worsen with activities that involve repetitive bending and straightening of the knee under load (e.g. running). This repetitive movement can cause the Iliotibial band near the knee to rub against the structures lying underneath (bone and bursa). When this friction is too much, it causes an inflammatory response and pain.
Causes of ITB Syndrome
There can be many contributing factors to ITB Syndrome. Some of the most common causes include:
- Poor hip and knee control (e.g. knees falling in with running or cycling)
- Tight hip muscles
- Weak hip muscles
- Poor foot control (e.g. foot arch rolling in)
- Sudden significant increase in exercise load
- Endurance training (e.g. training for a marathon.
Treatment of ITB Syndrome
Depending on the cause, there are many ways that we can address ITB syndrome. Most importantly, it would help if you considered activity modification of painful activities to prevent further aggravation. However, many exercises are beneficial for further recovery and preventing repeat episodes. Below are three fundamental exercises that are commonly included in the management of this syndrome.
Mobility – foam roll glutes
If your hip muscles are tight, it may be causing suboptimal positions and force distribution along the leg, and therefore increasing the likelihood of ITB friction. Foam rolling the glutes is a straightforward way to address this without stirring up any pain around the knee. All you have to do is sit on a foam roller with the injured leg crossed over the other and roll up and down along your glute muscles.
Control – avoid the knee falling in.
If your knee falls in when you run, this can put more tension along the ITB, increasing the likelihood of ITB syndrome. An excellent control exercise that helps stop the knee from falling is a lunge, with the focus on pushing the front knee out to the side.
Strength – hip muscles
The stronger your hip muscles are, the more load they can take, which means they offload the outer knee. A necessary strengthening exercise for your hip abductor muscles involves lying on your side with your top leg straight, and lifting and lowering the full leg whilst keeping the hip steady.
It is important to note, whilst this exercise is an excellent starting point, that strength exercises are progressive. To more challenging exercises in a standing position, as this will help to improve strength further and reduce the chance of ITB syndrome returning.
If you believe you are suffering from ITB syndrome, book in with your Physio for a thorough assessment using this link. Once the cause is identified, a plan can be designed specifically for you and get you back to doing what it is you love.