ITB Syndrome (Iliotibial Band Syndrome) often called 'runners knee' is a very common injury. It is an overuse injury; this means that repetitive movement rather than a specific incident cause it.
The ITB is a long band of fascia that runs down the outside of the lower limb from the Iliac Crest (near the hip) to the tibia and the femoral condyle (lateral knee joint).
Irritation of this band is created as it slides backwards and forwards over the femoral condyle. This sliding creates excessive friction that causes irritation, then inflammation and pain. The sliding occurs when the knee is bent at 30 degrees (this is known as the impingement zone and commonly the point at which heel strike occurs).
ITB syndrome can be due to a number of reasons. These include altered biomechanics due to muscular imbalances, whether this is weakness or hyper tonicity (tightness), sudden increase in physical activity, a change in training and excessive exercise without giving the body a chance to recover. Muscles that are commonly weak or hypertonic are the gluts, hip rotators, vastus medialis (medial quad) and weak core muscles.
The severity of the syndrome can vary greatly, however one common aspect is if you don’t make changes to your activity then it will get worse. This is due to scarring which can occur to the bursa, that is there to allow the ITB to flick over the femoral condyle without pain.
Most common symptoms are pain on the lateral aspect of the knee, pain worsening with continued activity, swelling on the outside of the knee, pain due bending (particularly early, around 30 degrees), hip pain (either anterior, posterior or lateral) and pain when lying on the effected side.
Most people with ITB syndrome who undertake appropriate care should start to feel better within a few weeks. The most important things to do are to find the cause of your symptoms, reduce acute pain and inflammation and lengthen your ITB. Other things to do include modifying your exercise regime, normalise the hip, knee and low back, strengthen and lengthen lower limb muscles, improve your proprioception, agility and balance as well as correct your running/landing technique. As with most soft tissue injuries initially treatment includes rest, ice, compression and elevation. Anti-inflammatory medications can be helpful but make sure you are aware of potential side effects and interactions with other prescription drugs you may be taking. From here your health practitioner has many options of how to treat your syndrome these may include: adjustments, mobilisations, soft tissue work, electrotherapy, dry needling and taping.
Dr. Steve Smith
B.Chiro. Sc., M.Chiro
Avalanche Chiropractic
44 William Street Raymond Terrace
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