ILIOTIBIAL BAND SYNDROME

The iliotibial band (ITB) is a long tendon-like structure that extends from the pelvis to just below the knee. It helps straighten the knee, move the hip sideways, and stabilize the leg. Overuse of the ITB is common in runners because the running action causes repeated bending of the knee and rubs the tendon against the outer side of the femur, near the knee. The friction can result in inflammation and pain in the tendon, or iliotibial band syndrome, which can also lead to bursitis. ITB syndrome can result from overtraining, muscular imbalances, poor running technique, biomechanical abnormality, and/or sudden changes to training routine.

WHAT ARE THE SYMPTOMS?

The first sign may be pain on the outside of your knee, particularly when walking down stairs. Running, especially downhill, may make the pain worse. You may also notice swelling and/or tightness, and a thickening of tissue along the outer side of your upper leg. Your knee may also be painful when you try to bend or straighten it and you may experience weakness when you move your hips sideways.

WHAT IS THE TREATMENT?

Stop any activity that causes or increases pain. Follow the RICE procedure and seek medical attention. If iliotibial band syndrome is left untreated you can experience long-term pain in the knee and hip. Your doctor will assess your symptom, and may suggest an ultrasound or a MRI scan to confirm the diagnosis. You will be advised to rest, continue applying ice to the injury for a few days and take pain-relief medication. You may need to visit physical therapist for treatment and exercises that stretch the ITB, correct any muscle imbalance, and improve muscle strength. If your physical therapist detects any biomechanical abnormality, you should be prescribed insoles or orthotics to wear in your running shoes.

WHEN CAN I RETURN TO RUNNING?

With rest and pain-relief medication, you should recover fully withing two months and be able to return to training. On the rare occasion that surgery is necessary, most people recover fully within two months of the operation after a program of rehabilitation.