Iliotibial Band Syndrome

Introduction

The Iliotibial band (or IT band) is an extension of fibrous fascia that extends from the top of the plevis, down the side of the leg, and attaches to the lateral aspect of the knee. The IT band is involved in flexion and extension of the knee, and as a result, is a key player in activities such as running, cycling, weight-lifting (especially squats), and hiking.

It is commonly injured in runners. Especially those that have increased distance recently or amount of training. The IT band rubs against the tibia during knee flexion and extension, and thus becomes inflammed after repetitive movements. Pre-disposing factors include old shoes, and excessive heel wear, running in the same direction on a pitched surface, leg-length discrepancy, and lack of stretching (or warm up before stretching).

Signs and symptoms of IT Band Syndrome Include:

1. A sharp pain over the lateral femoral condyle posteriorly
2. Pain that starts half-way through a run
3. Hypertonic muscles and trigger points found in tensor fascia lata, quadriceps, and hamstrings
4. Weak hip abductors
5. Increasing pain on running or walking when the foot strikes the ground

Treatment:

Activites that aggravate the condition should be curtailed or avoided completely. If actively inflammed the RICE method of treatment should be in the fore-front (Rest, Ice, Compression, Elevation).

In the long term, orthotics can be prescribed to help improve the mechanics of the feet and to reduce stresses on the knee joint. Soft-tissue therapy, aimed at the aggravated muscles, including the IT band, can help with any residual tightness exhibited. Proper stretching should be done for the IT band, including a proper warm up before any activity or stretching is done. Shockwave treatments and/or laser can help with the healing process. A rehab program will address muscle weakenss in the hip abductors (gluteal muscles), as well as strengthening the quadriceps and hamstrings.

The following is a good stretch for the IT band. But make sure the tissue is warm before proceeding to do so. A hot towel placed on the tissue can help warm it up, or you can also do something like 20 jumping jacks, to help warm up the tissue.

1)Stand upright
2)Cross the involved leg BEHIND the opposite leg
3)Lean to the uninvolved side until a stretch is felt across the affected iliotibial band
4)Hold for 30 seconds
5)Repeat X 5

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