Iliotibial Band Syndrome
In my practice I see many people who suffer from Iliotibial band syndrome. Iliotibial band syndrome is a common injury to the thigh, generally associated with running, cycling, hiking or weight-lifting (especially squats). Also known as ITBS.
ITBS is one of the leading causes of lateral knee pain in runners. The iliotibial band is a superficial thickening of tissue on the outside of the thigh, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. This band is crucial to stabilizing the knee during running, moving from behind the femur to the front while walking. Continual rubbing of the band over the lateral femoral epicondyle,combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed.
ITBS symptoms range from a stinging sensation just above the knee joint (on the outside of the knee or along the entire length of the iliotibial band) to swelling or thickening of the tissue at the point where the band moves over the femur. The pain may not occur immediately during activity, but may intensify over time, especially as the foot strikes the floor.
The causes of ITBS can result from one or more of the following training habits,anatomical abnormalities, or muscular imbalances:
Training habits:
Always running on a banked surface (such as the shoulder of a road or an indoor track) bends the downhill leg slightly inward and causes extreme stretching of the band against the femur
Inadequate warm-up or cool-down
Excessive up-hill and down-hill running
In cycling, having the feet"toed-in" to an excessive angle
Running up and down stairs
Hiking long distances
Rowing
Abnormalities in leg/feet anatomy:
High or low arches
Supination of the foot
Excessive lower leg rotation due to over-pronation
The force at the knee when the foot strikes
Uneven leg length
Bowlegs or tightness about the iliotibial band. Excessive wear on the outside heel edge of a running shoe (compared to the inside) is one common indicator of bowlegged for runners.
Muscle imbalance:
Weak hip abductor muscles
Weak/non-firing multifidus muscle
While ITBS pain can be acute, the iliotibial band can be rested, iced, compressed and elevated (RICE) to reduce pain and inflammation, followed by stretching. Using a foam roller to loosen the iliotibial band can help prevent and treat ITBS although the treatment itself can be very painful to some. Also, an ultra sound machine can be used around the area to relax it, followed by a machine that utilizes electrode stimulation to the area to further relax it. This can result in more comfort and/or a wider range of motion. Consulting with a doctor or referring to a registered physiotherapist, athletic trainer/therapist, or a massage therapist would be the best solutions. Custom foot orthotics may treat this condition by controlling the amount of inversion (medial rotation) of the foot and thus reducing rotation of the leg and knee (which creates friction of the iliotibial band against the outside of the knee).
A very effective way of off-loading the ITB and restoring VMO control/normal medial glide of the patella, is via "McConnell's Taping", or taping pulling the knee medially (inward). Tape from the bottom half of the patella, to under the knee over the patella tendon. When this is done firmly, they should notice it feels 'stronger' or 'less painful.'
Other treatments available for this injury use a compression wrap to mobilize the ITB where the tendon meets the knee. This is called an 'IT band compression wrap.’ In severe cases where a conservative approach has failed, surgery can be a good option.
Angela Shirk Sneed, ATC, LAT
Advanced Athletic Training Solutions
No comments:
Post a Comment