Iliotibial band syndrome is common in distance runners or athletes that significantly increase their training schedule. The repetitive flexion and extension of the knee when running or cycling can cause friction on the outside of the knee. It’s this action that inflames the tendon causing the pain and snapping consistent with the iliotibial band (ITB) tendonitis. The bursa below the iliotibial tendon is stressed contributing to the inflammation. The band extends from above the hip joint where it is attached on the pelvis to just below the knee joint on the tibia or the large bone of the lower leg. Not all athletes or runners are affected by this condition. It may be precipitated by biotechnical problems with the running gait or other biomechanical causes. Some clinicians believe muscular weakness, muscular tightness, the amount of time training or the number of miles of training per week contribute to the condition. The definitive cause is elusive.
Symptoms of the Iliotibial Band Syndrome
Symptoms are noticeably less with rest or inactivity and made worse with continual movement such as running or cycling. The more common symptoms include:
- Swelling and diffuse pain felt over the outside of the knee. The area is consistent with the lateral femoral condyle or tibial tubercle.
- Snapping may be felt or heard as the knee is flexed.
- The pain becomes worse after running for several minutes. It may intensify going down hills.
- Sitting with the knee flexed for a long period of time may aggravate the symptoms.
treatment of Iliotibial Band
The ultimate goal of treatment is to reduce inflammation. This may be accomplished by the following:
- Control Pain and Inflammation – Rest and ice treatment along with discontinuing aggressive activities or athletic training schedule.
- Biomechanical Issues – Determine if there are issues with pelvic mechanics or leg length inequality. An anatomical leg length difference would necessitate placing a lift in the shoe of the short leg to balance the pelvis.
- Review Footwear – Determine if orthotics may be beneficial.
- After Acute Phase
- Exercise to balance the muscles of the upper leg to include stretching
- Soft tissue massage
- Graston Technique
- Cross training is recommended to maintain endurance. The activity should not stress the iliotibial band. This could include activities such as swimming.
If patients do not respond to conservative management, injections or surgery may be necessary. The use of pharmacology is not in the scope of this article.
Iliotibial band syndrome is a condition that can be difficult to treat successfully. Athletes are often impatient and cannot accept the fact that it takes time to resolve injury problems. The injured worker may have limitations and restrictions with work. Anyone suffering from iliotibial band syndrome may have to endure modifications of activities of daily living. A through explanation of the problem and the use of educational material is helpful to overcome the athlete’s or patients resistance to treatment recommendations.
The doctors at Coon Rapids Chiropractic Office have experience in the care and treatment of iliotibial band injuries.