Iliotibial band syndrome is one of the leading causes of knee pain in runners. The iliotibial band(IT band) is a thick band of fascia on the outside of the knee, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running, as it moves from behind the femur to the front of the femur during activity. When the IT band isn’t working properly, movement of the knee (and, therefore, running) becomes painful. It is an overuse injury causing pain on the outside part of the knee especially while running, when the heel strikes the ground.
Runners can develop ITBS symptoms should they make mistakes in their running. Roads are uneven or banked with the center of the road higher than the outside edge to allow for water runoff. If a runner always runs on the same side of the road, it produces the same effect on the body as having a leg-length discrepancy. One leg is always downhill compared to the other, and the pelvis has to tilt to accommodate the activity. Running too many hills can also cause inflammation of the IT band.
Bicyclists may develop IT band inflammation should they have improper posture on their bike and “toe in” when they pedal. This can cause the same effect as bowed legs, increasing the angle of the IT band as it crosses the knee, increasing the risk of inflammation.
- Pain and sometimes swelling on the outside of the knee. The best way to tell if you have ITBS is to bend your knee at a 45-degree angle. If you have an IT band problem, you’ll feel pain on the outside of the knee.
- A sharp or burning pain on the outside of the knee when running. Where “running through the pain” is not possible.
- Pain subsides shortly after running, but quickly returns on the following run.
- Some runners experience a snapping or popping with swelling on the outside of the knee or just below.
- The pain may radiate along the course of the IT band all the way up to the outer side of the thigh to the hip.
- R.I.C.E (Rest,Ice,Compression,Elevation) I can’t stress this enough!!!!! The RICE works VERY well and should be done for most runner injury, and this one is no exception! The combination of RICE helps heal injuries healthier and quicker than just ignoring it, REST: keeps you off your feet, ICE: helps reduce swelling, COMPRESSION: promotes blood flow, and ELEVATION: helps blood move freely to prevent swelling or pain. This should be done for at least 20 minutes, immediately after a run.
- Back off your regular mileage, don’t push your pain threshold too far, having this injury won’t allow you to. But you can cross train, like swimming, rowing, and pool running, stair climbing is not ideal as it’s too similar to running.
- Taking anti-inflammatory over the counter meds are a reliever. Ibuprofen, and naproxen seem to be very effective. (Advil,Motrin,Aleeve)
- Physical therapy may be needed to decrease the inflammation at the IT band. Some treatments focus on flexibility and stretching. Friction rubbing may occur over the IT band at the femoral epicondyle to break down inflammation and scarring.
PREVENTION AND STRETCHES:
- Make sure you have proper running shoes fit to aid your running comfortably.
- Avoid running the same EXACT route, change it by running on different surfaces, or sides of the roads.
- Avoid excessive hill running(especially downhill). At least until your pain is gone.
- Don’t do a dramatic mileage increase, do 10% increases at a time to avoid injuries.
- FOAM ROLL!!!! Place the foam roll on the ground and place the outside of your thigh on the roll so that you can roll the length of your thigh. Place your hands on the floor and use them to pull your body back and forth over the affected area of your leg for a minute. Do not roll over bone, just muscle. Roll over both legs a few times a day.
- Lay on your side and pull foot up to back of buttocks. Cross the uninjured leg over the injured leg and push down, hold for 30 seconds.
- Side leg lifts, put the back of the leg and buttocks against the wall, slide the leg up the wall and hold at the top for 5 seconds then slide back down. Point toes down.
- Cross injured leg over the uninjured side and pull the leg as close to your chest as possible. Try to hold for 30 seconds.
- In standing position, cross injured leg behind and lean towards the uninjured side. This stretch is best performed with arms over the head, creating a “bow” from ankle to hand on the injured side. Similar to the photo but legs crossed.
- And yes of course KT TAPE has an effective application for this injury as well, there is an IT hip application and an outer knee, I love KT Tape because it’s effective, and doesn’t get in the way, you don’t even feel like you having anything on, here are both instructional videos!
I hope this help put my fellow runners!!!! I will post a few more stretches and other exercises later on.
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