Iliotibial band syndrome (ITB syndrome) is a common injury and causes intense and sharp pain at the lateral (outside) part of your knee, especially any movement require bending of the knee.
The pain area is in contrast with runners knee, which causes pain at the front of the knee.
ITB syndrome is an overuse injury mainly affecting runners, cyclists and avid hikers.
Sign and Symptoms
The main sign and symptom of ITB syndrome is a sharp and intense pain at the outside of your knee, pain is increased when you:
- Bend your knee, but pain gradually becomes less as you bend beyond 30 degrees.
- Walk, especially when your heel strikes the ground.
- Pain and tenderness at the outside of knee when touched.
- Clicking sensation/sound when the knee is bent.
Risk Factor and Cause
The following are the risk factors for ITB syndrome:
- Gender. Female has a higher risk of ITB syndrome due to anatomical differences with male, such as a wider hips and a larger Q-angle. This places greater stress and pressure on the knees.
- Genetics. If you are born with a naturally shortened iliotibial band and without proper care, you may be prone to ITB syndrome.
- Improper running shoes. You should choose the right running shoes as this is the first step for injury prevention. An improper running shoes causes a long list of potential injuries.
- Flat foot or high arch. As a flat foot or high arch person, you are placing excessive stress and pressure on your other joints as well. Get this fix as soon as possible.
There are many possible causes of ITB syndrome, but these are the most common ones:
- OVERTRAINING! When you increased your training volume/intensity abruptly over the week, you are prone to many injuries other than ITB syndrome.
- Poor biomechanics of your hips and/or knees. This leads to inward rolling of the knees and hips during running.
- Weak gluteal, hip flexor, hip adductor muscles.
How Do You Treat It?
If you have mild to moderate pain, you should follow the RICE protocol (rest, ice, compression, elevation):
You need to stop running immediately, apply ice on your affected knee(s) for 15-20 minutes 3 times per day, wear a knee brace and elevate your knee above your heart level (do this by laying down and raising your leg on to a higher platform).
If you have severe to unbearable pain, please consult your local physician or physiotherapist as soon as possible.
After you pain has subsided, you’ll need to rehabilitate your affected knee to restore its range of motion, strength and flexibility.
Rehabilitation is crucial in restoring the function of your affected limb and prevention of recurring injuries.
You’ll need to begin stretching as soon as pain subsided, focus stretching the ITB band, quads, hamstring and hip flexors. This is because these muscles usually tighten up due to the injury.
You can do these stretches 5-8 repetitions, hold 10 seconds each, every alternate day.
You’ll need to strengthen your lower limbs, mainly your gluteal muscles.
There are many ways you can strengthen your gluteal and your hips after recovery, and it is crucial that you do it to prevent recurring injuries.
The squat is the simplest and most basic lower limbs exercise which strengthens most of your lower limb muscle groups.
You can start this exercise with 3 sets of 10 repetitions, every alternate day and increase 2 repetitions every week.
Side leg raise is an exercise to strengthen your gluteal muscles, especially the gluteal medius and gluteal minimus.
You can start this exercise with 3 sets of 10 repetitions each leg, every alternate day and increase 2 repetitions every week. You can do this at home without any equipment.
Prone hip extension is a good exercise to target the gluteal maximus and hamstring. You should do this single leg and not lifting up both legs.
You can start this exercise with 3 sets of 10 repetitions each leg, every alternate day, and increase 2 repetitions every week.
This exercise can be done at home without any equipment.
How Do You Prevent It?
Prevention can mean prevention of potential injuries and prevention of recurring injuries (after recovery). These are some tips that you can follow to prevent injuries:
- Don’t be cocky and overconfident that you are immune to any injuries.
- Adhere to the FITT principle (Frequency, Intensity, Time, Type). This is a great way for you to monitor your training volume and intensity.
- Always warm up and cool down before and after your runs, respectively.
- Get a good quality footwear with adequate heel cushion and good arch support to prevent ankle or knee injuries.
- Incorporate a proper strengthening and stretching program into your usual training routine to address any existing strength and flexibility issues, respectively.
- Learn and implement a proper running technique such as ChiRunning technique.
- Sufficient rest between hard workout to allow your body to repair itself.
It is a mental suffering for avid runners or cyclists to be suffering from an injury.
You should not stress yourself while you are injured as stress slows the recovery process.
Depending on the severity of your injury; if you manage it well, you will be up and running within weeks post-injury.
Don’t forget to rehabilitate your injured limb.