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Iliotibial band syndrome

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Knee pains from Shutterstock.
Knee pains from Shutterstock.
Maridav
The iliotibial band is the ligament or thick band of tissue that runs on the outside of your thigh from your hip to your shin (also known as the tibia).  
On the way, it attaches into the side of the kneecap and helps to stabilise and move this joint. This ligament surrounds the muscles, and when they contract, they increase the pressure on the iliotibial band. When the same muscle is in constant use, the iliotibial band can become tight or inflamed.

This usually manifests in the soft tissues of the lower thigh.

Read: What is knee pain?

ITB syndrome is the most frequent cause of pain on the outside of the knee for runners. In fact, it is estimated that 12% of overuse injuries in runners are as a result of ITB syndrome.

Overuse leads to this injury not only in runners, but in all people who cycle, who walk long distances, or who take part in any frequent weight-bearing exercise that involves repetitive motion of the legs.

What causes ITB syndrome?

Constant rubbing or repetitive friction of the iliotibial band against the bone on the outer part of the knee can irritate the ligament itself, or the tissue underneath. Near the knee, the iliotibial band narrows, and the band can rub against the bone of the knee, and causing inflammation.

There is no single cause of ITB syndrome, and it is not necessarily the result of any traumatic or specific injury, or indeed only sports injuries. Any activity that causes the leg to turn inward constantly can lead to ITB syndrome. This is a particular problem for people who have structural abnormalities in the legs, such as bowlegs.

Causes can include the following:

• Legs that are not of equal length
• Excessively flat feet or high arches
• Bowlegs
• A structural abnormality that causes the IT band to be short and tight
• Any other ankle, hip or foot problems
• Muscle imbalances, e.g. when your quadriceps are stronger than your hamstrings
• The angle of the knee joint
• Limited ankle range of motion
• Hip problems (common in long-distance runners)

Doing any of the following things can increase your risk for ITB syndrome:

• Suddenly increasing the distance that you run
• Wearing worn-out running shoes
• Wearing the wrong shoes for a particular activity
• Inadequate stretching exercises before a running session
• Running excessive distances
• Incorrect training technique
• Over-striding
• Doing a lot of uphill or downhill running
• Using equipment that might not be a proper fit for you

Read: Causes of knee pain

The symptoms and diagnosis of IBT syndrome


Swelling and pain on the outside of the knee is usually the most noticeable symptom. There is an easy way to find out if you have ITBS syndrome: bend your knee at a 45-degree angle and see if you feel pain on the outside of the knee. This could be a dull ache, or a burning feeling. You could feel pain during exercise.

You could also feel pain in the hip, or feel a snapping or creaking when you bend and then straighten your knee. ITB syndrome pain tends to get worse over time if not properly treated.

There are several tests that can be done to diagnose the exact problem – whether it is the tightness of the ITB, or the specific area where pain is experienced when you place your full weight on the knee, or when you flex your leg.

An MRI could reveal whether your ITB is thickened, and therefore inflamed.

Read:
Diagnosing knee pain

Treatment of IBT syndrome


These depend on the extent of the injury and can include the following:

• Resting the knee, by interrupting your training programme, or doing non-weight bearing activities such as swimming
• Walking with shorter strides
• Doing side stretches
• Apply ice, or heat
• Over-the-counter painkillers and possible a cortisone injection
• Surgery if none of the above treatments have been effective
It is important not to ignore ITB syndrome, as it can easily become a chronic problem.

Read more:

Symptoms of knee pain
Treating knee pain
Preventing knee pain



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