A very common ailment for most runners which I have been fortunate enough not to have yet (touch wood) is ITBS or iliotibial band syndrome. This issue is characterized by pain on the outside of the knee, which is the most common or in some instances up higher along the lateral side of the thigh.
The IT band is a connective tissue of that begins on the forward portion of the crest of the hip, runs down the side of the thigh blending in with the fascia lata into the lateral crest of the tibia. The common proposed way in which the ITB becomes injured is through repetitive impingement due to overuse and mechanical factors. Both friction and compression factors are also suggested to be involved.
The ITB works to help add stability of the femur through tension during gait. Specifically it helps the lateral ligament in the knee to assist with the forces during heel strike that normally abduct the femur and destabilize the knee.
Whilst the exact causes and risks have yet to be nailed out, there are some pretty strong risk factors associated with developing ITBS,
- Overuse injury – improper training or loading progressions
- Running hills, crowned roads or oval tracks
- Some biomechanical indicators, increased hip and ankle internal rotation, increased femoral abduction (also know as knock-knee)
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Due to the ambiguity in the exact way in which people develop ITBS, the exact treatment isn’t so clear-cut. ITBS most commonly responds initially to conservative treatment, being relative rest, icing, changing up the activity, soft-tissue mobilization, stretching and progressive strengthening. ITBS does not respond to one physical therapy better than another so typically a combination approach is looked at.
The Strengthening exercises focus on gluteus medius (hip hikes, clams, step downs, lateral walks, banded variation exercises.
The importance of biomechanical factors when running is also making a large difference in the way ITBS is treated. At The Physio Movement a gait analysis is a must-do part of your initial assessment.
So if you are an unfortunate runner to be suffering from ITBS, come visit both myself as an Exercise Physiologist or our Physiotherapists who specialise in running related issues and we will put you on the appropriate plan.
By Callum Morrison
