knee pain

IT Band Syndrome

Iliotibial Band Syndrome or IT band syndrome, is one of the most common overuse injuries for runners. It typically occurs when the iliotibial band, the ligament that runs down the outside of the thigh from the hip to the shin, is tight or inflamed.

IT band anatomy

Here’s a little anatomy lesson. The iliotibial band (IT band) is also known as the iliotibial tract. It’s a long connective tissue that runs along the outside of your leg from the hip to the knee and shinbone.

it band syndrome

The IT band helps to extend, abduct, and rotate your hip. It also helps to stabilize and move the side of your knee while protecting the outer thigh.

The IT band attaches to the knee and helps move and stabilize the joint. When the IT band isn’t working properly, knee movement becomes painful. So much pain that it can completely sideline a runner for weeks, or longer.

Symptoms of IT Band Syndrome

Because the most notable symptom is typically swelling and pain on the outside of the knee, many runners mistakenly think they have a knee injury. The best way to tell if you have ITBS is to bend your knee at a 45-degree angle. If you have an IT band problem, you’ll feel pain on the outside of the knee.

Common causes of IT Band Syndrome

ITB syndrome can result from any activity that causes the leg to turn inward repeatedly.

This can include the following:

Unlike many overuse injuries, however, IT band pain afflicts seasoned runners almost as much as beginners. When the iliotibial band comes near the knee, rubbing can occur between the band and the bone. This causes inflammation. Iliotibial Band Syndrome is more common in women because hips tilt in a way that causes their knees to turn in.

Additional risk factors for developing ITBS include:

  • Preexisting IT band tightness
  • Prior IT band injury
  • Weak hips
  • Weak gluteal and abdominal muscles
  • Weakness or lack of flexibility
  • Weak knee extensor, knee flexors, and hip abductors
  • Knee arthritis
  • Flat feet

IT Band Syndrome treatment

Once you notice ITB pain, the best way to get rid of it for good is to rest immediately. That means fewer miles, or no running at all. In the majority of runners, resting immediately will prevent pain from returning. If you don’t give yourself a break from running, ITBS can become chronic.

  1. Lower your mileage
  2. Start Cross-training (Swimming, pool running, cycling, and rowing are all great options)
  3. Add side stretches
  4. Apply ice or heat
  5. Electrical stimulation

If your ITB problem doesn’t get better after several weeks, seek help from a sports-medicine professional. You may need a cortisone injection to break up scar tissue and help speed healing. But cortisone presents its own risks, as it can weaken ligaments and tendons.

Your last resort is surgery to release and mobilize the IT band.

Prevention of IT Band Syndrome

Here are some steps you can take to prevent Iliotibial Band Syndrome:

  • Decrease your mileage
  • Take a few days off if you feel pain on the outside of your knee
  • Walk before you start your runs
  • Replace old running shoes
  • Run in the middle of the road where it’s flat
  • Limit running on concrete surfaces
  • Look into orthotics

IT Band Stretching

Stretching can help with tightness and flexibility.

Standing stretch

it band stretch
  1. Cross your right leg in front of your left and press firmly into both feet. Try to have your feet about shoulder-width apart.
  2. Lean to the right as far as your body will allow, feeling the stretch in your knee and outer hip.
  3. For a deeper stretch, you can reach your left arm overhead.
  4. Press your left hand into a wall for added stability.
  5. Hold the stretch for up to 30 seconds.
  6. Repeat 3x each side.

Wide Leg Stretch

  1. While standing, move your feet so they’re wider than your shoulders.
  2. Turn your toes in slightly with a slight bend in your knees.
  3. Slowly bend at the hips forward, drop your hands to the floor.
  4. Use a chair for support if your hands don’t reach the floor.
  5. Press into the outer edges of your legs and feet.
  6. Feel the stretch on the outside of your lower body.
  7. Walk your hands to the right and turn your upper body to the right.
  8. Next, put your hands on the outside of your right leg.
  9. Hold for 15 seconds.
  10. Repeat on the left side.
  11. Do each side 2 – 3x.

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