Iliotibial band syndrome, or ITBS, is the No. 1 cause of lateral knee pain in walkers and runners, notes the January 2009 issue of "Dynamic Chiropractic," and accounts for about 12 percent of all running-related overuse injuries. This common running-associated injury can be limiting and frustrating for all athletes. The sources of ITBS are a combination of extrinsic and intrinsic factors including leg length inequality, overtraining, improper arch support, overpronation of the foot and running on uneven surfaces. Prevent ITBS with correct training technique, proper footwear and adequate rest between runs. You can overcome ITBS with chiropractic treatment and common-sense self-treatments.
Anatomy
The iliotibial band, ITB, is a thick band of fibrous tissue that originates in the lateral hip, runs along the outside of the thigh and attaches to the knee and upper lateral lower leg. The "Dynamic Chiropractic" article, authored by Mark Charrette, DC, states, "The ITB controls and decelerates adduction of the thigh as the foot is planted." This means the ITB works during every step to stabilize the hip and knee while running and walking.
Symptoms
Tautness in the iliotibial band causes it to rub against the bony prominences on the lateral aspect of the knee and hip. This creates friction and pain over these bony areas and often throughout the entire lateral thigh. ITBS pain is often described as sharp and/or burning and usually affects only one leg. The pain of ITBS is most frequently felt when running or walking up and down stairs and is often tender to the touch.
Athletes
Iliotibial band syndrome is an overuse injury, resulting from the cumulative effect of repetitive stress. It is more common in runners who run up and down hills and stairs. Running on rough terrain, running on uneven surfaces, running on banked streets or tracks contributes to ITBS because of the stress on the band to keep the hips and knees level. Also runners or walkers who over-stride get ITBS due to constant overstretching of the band. Other athletes commonly diagnosed with ITBS include hikers, volleyball players, basketball players, soccer players, skiers, bowlers, cyclist who use an excessive toed-in position, and athletes that perform a high number of squats.
Prevention
Prevention of the occurrence of iliotibial band syndrome is the best medicine. Stretching before and after running helps to lessen the tightness of the lower extremity muscles and increase muscle flexibility. Routinely stretch your iliotibilal band and your thigh, back and gluteal muscles. Strengthen the medial head of your quadriceps, your hip adductors and muscles of the arch of your foot. Wear good-quality running shoes with proper fitting arch supports and put insoles in your dress shoes to prevent overpronation of the feet. Run on level surfaces or alternate directions on the road to prevent the same leg from always being on the lower side of banked streets. Always increase training intensity gradually, including mileage, frequency and incline running.
Treatment
If symptoms occur, do not hesitate to seek professional care from a chiropractor to re-establish proper nerve flow and restore proper skeletal motion to the spine, hips and lower extremities. Ice the lateral knee for 15 to 20 minutes after a run to decrease inflammation and pain. You can apply self-trigger point, or pressure point, therapy by rolling your lateral leg over a tennis ball or foam roller. When you sleep on your side, place a small pillow between your knees. If you sleep on your back, use a leg wedge or a pillow under you knees and lower legs. If necessary, discontinue running temporarily and substitute another exercise such as swimming or pool running.
References
- University of Illinois at Urbana-Champaign: McKinley Health Center: Overuse Knee Injuries
- American Academy of Family Physicians: Iliotibial Band Syndrome: A Common Source of Knee Pain
- "Dynamic Chiropractic"; Lateral Knee Pain & Orthotic Support; Mark Charrette, DC; Sept. 2009
- American Academy of Family Physicians: Hip Pain in Athletes
- National Council on Strength and Fitness: Iliotibial Band Syndrome
