Sep 14, 2014
Iliotibial band (ITB) Friction syndrome is one of the most common causes of lateral (outside) knee pain that we see, especially in runners. It’s also probably one of the most frustrating problems both for myself and for the patient. It is largely an overuse injury due to the repetitive nature of activities such as running. It often starts out as a little ‘niggle’ however gradually worsens & worsens until it quite literally will stop you in your tracks.
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Jun 12, 2012
Iliotibial Band (ITB) friction syndrome is a common cause of knee pain found predominantly in runners. Pain is usually felt on the outside of the knee and is made worse by running, particularly down hills and stairs.
The ITB is a band of fascia that originates at the side of the hip, runs along the outside of the thigh crossing the knee joint and inserting onto the side of the shin bone. It is a naturally tight structure in just about everyone but when it gets excessively tight it can begin to rub and friction over a bony prominence on the side of the knee. This rubbing causes the ITB to become inflamed and can cause debilitating pain.
Not all runners get ITB friction syndrome and there generally isn't one single reason why people develop this condition. It's usually a mixture of altered biomechanics and/or changes in training be it new surface, different footwear or sudden increase in training.
There are a few structural things that can predispose certain individuals to suffering from ITB friction syndrome.
1. Flat or pronated feet: basically this means that you have less of an arch on the inside of your foot than normal, or your arch collapses as you walk. This can put extra steps on certain structures including the ITB during the running cycle.
2. Poor pelvic stability. When we run our pelvis should stay level or symmetrical as we take each stride. If our pelvic stabilisers are weak you begin to get rotation of the pelvis and structures such as the ITB are put under undue stress causing them to become tight
3. Leg length discrepancy: some people are naturally born with one leg slightly longer than the other. This will alter your gait and running cycle possibly contributing to extra pressure on the ITB
There are also some simple ways to avoid developing this problem.
1. Ensure you have good supportive footwear: it's about last years runners.... Ditch them and invest in a new pair... They will be worth it. If you train regularly (3-4 x per week) you should be buying new shoes at least every 6 months, and if majority of your training is running probably more often.
2. Mix it up: everyone loves a good hill sprint session but this shouldn't be done everyday!! Hills and stairs place a great amount of stress on our knees. Ensure your exercise program is a balance if running, interval and resistance training.
3. Ease into it: by all means throw yourself into training but you need to be smart about how you do it. Start small and build up in distance and frequency.
4. Prehab: if you know your upping your training take a preventative approach. The foam roller is the most effective way of loosening the ITB. These can be found at most gyms and 5 minutes is all it takes. I will warn you it's not pleasant. ( If your not sure how to do this YouTube have some excellent videos)
If you are worried you are starting to develop knee pain ensure you consult your physiotherapist. It's definitely one to catch early. I suffered with ITB friction syndrome for a long time and your running training will literally come to a halt, trust me it can be an extremely frustrating recovery.. I would advise a preventative approach!