Monday, 17 March 2014

Iliotibial band syndrome, what is it and how do you treat it

What is Iliotibial band syndrome (ITBS)
ITBS is a common injury amongst runners[1] and occurs when excessive irritation causes pain on the outside part of the knee. The iliotibial band is a type of soft tissue that runs along the side of the thigh from the hip to the top of the shin, just below the knee. As it nears the knee, its shape thickens, as it crosses a prominent area of the thigh bone (femur), called the lateral femoral condyle. Near the hip, the iliotibial band attaches to two important hip muscles, the Gluteus Maximus and the Tensor Fascia Latae.

Every time you bend or straighten you knee, the IT band crosses the lateral femoral condyle. This friction can lead to irritation and inflammation on the outside of the knee, causing pain.
It often occurs in activities with a lot of repetitiveness such as running and cycling, and is a sign of overuse. There can be several structural causes to this overuse injury;
- Abnormal contact between the IT band and femur
- Poor alignment and/or muscular control of the lower body
- Prolonged pinching or rubbing forces during repetitive activities.

It is often the IT band that is too tight, either the band itself or the two hip muscles that are too tight and pulls the IT band tighter, or weak hip muscles, such as the Gluteus Medius.

Treatment
Rest:
Nobody really wants to take a break from working out, so I'm guessing this advice is the least favourite, though it might actually help. At least in the beginning, so the inflammation can get some rest.



borrowed from Leanitup.com
Tight IT band:
If the IT band is too tight, you can try and stretch the band by using a foam roller, as well as stretch the Tensor Fascia Latae and Gluteus Maximus muscles.

This might hurt, so be gentle.


Weak Gluteus Medius
The Gluteus Medius is a hip-stabilizing muscle, and helps keep the hip steady, when you walk or run. If the muscle is weak, your hip will need something else to stabilize it, and that means the IT band takes over, putting more stress on the band and the area of friction.
In order to fix this, you need to strengthen your Gluteus Medius, and that can be done with one (or all) of the following exercises;
- Side-lying hip abduction (do 3x15 with each leg pr. day for a few weeks)
- Single-leg squat (do 3x10 with each leg 2-3 times per week for a couple of weeks)
- Single-leg deadlift (do 3x10 with each leg 2-3 times per week for a couple of weeks)
- Clam (do 3x15 with each leg pr. day for a few weeks)

These exercises are some of the best for Gluteus Maximus activation[2], and will help relieve ITBS pain.

Remember, if you think you have ITBS but haven't gotten it diagnosed, go to your general physician or a Physiotherapist and they will help you out.
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References:
  1. WebMD, Common Running Injuries: Prevention and Treatment. Located at: http://www.webmd.com/fitness-exercise/running-injuries-causes-prevention-treatment?page=2 Accessed 17.03.2014
  2. Distafano LJ, Blackburn JT, Marshall SW, et al. Gluteal muscle activation during common therapeutic exercises. (2009); J Orthop Sports Phys Ther. 2009 Jul;39(7):532-540 Located at: http://www.ncbi.nlm.nih.gov/pubmed/19574661 Accessed 17.03.2014