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In this article we will discuss what ITBS is, the causes/symptoms and treatment for this condition…
What is Iliotibial Band Syndrome? (ITBS)
ITB syndrome (also known as runner’s knee) is where the fascia called the iliotibial band gets irritated or swollen from compression against the lower end of your thigh (femur) bone, where it attaches to your knee. This compression causes friction, resulting in inflammation and pain. It is a common overuse injury, often caused by activities that involve repeated knee bending, such as running, cycling, hiking, and walking long distances.
The iliotibial band is a thickened band of deep fascia that runs down the outside surface of the leg, which goes from the top of your pelvic bone to below your knee.
Its primary function is to stabilise the hip and knee whilst providing lateral support to the lower limb. This allows for a strong pillar-like structure on which we can stand (especially if standing on one leg) and helps to stabilise the pelvis during movement.
It also supports movements of the hip and knee through the action of the gluteus maximus and tensor fasciae latae muscles, which insert into the ITB.
What are the causes?
ITBS is caused by compression and friction where the iliotibial band crosses over the outside of the knee. A fluid-filled sac called a bursa helps the ITB glide smoothly over your knee as you bend and straighten your leg. Your ITB and the bursa can both start to become inflamed with repeated rubbing, which can lead to the pain of Iliotibial Band Syndrome. Listed below are some of the causes linked to ITBS
- Poor biomechanics (running or cycling technique), mainly inwards rolling knees and hips
- Tightness in the hip / gluteal muscles
- Weak hip / gluteal muscles
- Weak inner quadricep (thigh) muscles
- Weak core muscles
- Poor foot arch control – flat feet
- Worn-out or unsuitable trainers
- A sudden increase in mileage or intensity of activity
- Excessive hill running training (mainly downhill)
- Endurance running or cycling
What are the symptoms?
Symptoms of ITBS can include the following…
- Sharp or burning pain just above the joint line, on the outer part of the knee.
- Pain that worsens with a continuation of running or other repetitive activities
- Swelling over the outside of the knee.
- Pain going downhill or walking downstairs.
- Gradual onset of symptoms, which, if they persist for greater than four weeks, can cause significant sport or activity interference.
- Tenderness to touch on the bone on the outside of your knee.
How is Iliotibial Band Syndrome Diagnosed?
Your skilled clinician/therapist can help diagnose ITBS with the following:
- Assessing the range of movement and strength of your knees and hips.
- Assess muscle length and flexibility of the quadriceps, hamstrings, and gluteal muscles.
- Watching you move your knee and how you perform activities such as squatting, hopping, jumping, and running.
- Checking other regions of the body as needed, such as the feet and lower back. This will help to determine if other areas also require treatment to improve your condition.
- Gently, but skilfully, feeling around your knee joint and ITB to find exactly where it is most painful.
- Functional tests – You may be asked to perform specific activities that aggravate your pain, so the therapist can assess exactly what is causing the problem.
L. Russell – Sports Therapist.