October 2019 newsletter.
Text from: Sports Injury Clinic, The Sports Injury Clinic on the net.
Iliotibial band syndrome results in pain on the outside of the knee which is caused by friction of the iliotibial band on the side of the knee. It is also known as ITB syndrome.
Symptoms of ITB syndrome consist of pain on the outside of the knee, more specifically at or around the lateral epicondyle of the femur or bony bit on the outside of the knee. It comes on at a certain time into a run and gradually gets worse until often the runner has to stop. After a period of rest the pain may go only to return when running starts again. The pain is normally aggravated by running, particularly downhill. Pain may be felt when bending and straightening the knee which may be made worse by pressing in at the side of the knee over the sore part. There might be tightness in the iliotibial band which runs down the outside of the thigh.
Certain factors may make you more susceptible to developing runners knee or iliotibial band syndrome. A naturally tight or wide IT band may make someone more susceptible to this injury. Weak hip muscles, particularly the gluteus medius are also thought to be a significant factor. Over pronation or poor foot biomechanics may increase the risk of injury. If the foot rolls in or flattens, the lower leg rotates and so does the knee increasing the chance of friction on the band. Other factors include leg length difference, running on hills or on cambered roads.
Rest – Rest is important to allow the inflamed tendon to heal. Activities other than running which do not make the pain worse such as swimming or cycling should be done to maintain fitness.
Ice – Apply ice to reduce pain and inflammation. Ice should be applied for 10 to 15 minutes every hour until initial pain has gone then later 2 or 3 times a day and / or after exercise is a good idea.
Stretching exercises – Stretching exercises for the muscles on the outside of the hip in particular are important. The tensor fascia latae muscle is the muscle at the top of the IT band and if this is tight then it can cause the band to be tight increasing the friction on the side of the knee. Using a foam roller on the IT band and gluteal muscles can help stretch the iliotibial band and remove any tight knots or lumps in the tendon.
Strengthening exercises – Improving the strength of the muscles on the outside of the hip which abduct the leg will help prevent the knee turning inwards when running or walking and therefore help reduce the friction on the ITB tendon at the knee. In particular strengthening exercises for the tensor fascia latae muscle and gluteus medius such as heel drops, clam exercise and hip abduction are important.
Ultrasound – Use of electrotherapeutic treatment techniques such as TENS or ultrasound may help reduce pain and inflammation.
Training modification – Errors in training should be identified and corrected. These can include over training or increasing running mileage too quickly. As a general rule a runner should not increase mileage by more than 10% per week. Running across a slope or camber in the road for long periods or poor foot biomechanics should be considered. Also avoid too much downhill running.