What Causes Iliotibial Band Pain?

By Anna-Mart Kruger Physiotherapy www.physionam.com

Iliotibial band syndrome is typically caused by inflammation of the iliotibial band. IT band syndrome is a common injury in runners or other athletes that run for training or during their sports. The IT band acts primarily as a stabilizer during running and may become irritated from overuse. The pain is typically felt on the outside (lateral) aspect of the knee or lower thigh, but may be felt near the hip, and is often more intense when descending stairs, or getting up from a seated position.

Common Causes of IT Band Syndrome

• Overuse
• Increasing Training Too Quickly
• Overtraining Syndrome
• Returning from Injury Too Soon
• Faulty Biomechanics
• Other Training Errors

IT band syndrome is common in runners who perform unbalanced, repetitive exercise such as running only on one side of a crowned road, or only running one way around a track. Most roads slope off to the sides and running along the edge causes to the outside foot to be lower than the inside foot. This in turn causes the pelvis to tilt to one side and stresses the IT band.

The biomechanical abnormalities that may lead to IT band problems include: excessive pronation of the foot, leg length discrepancy, lateral pelvic tilt, and “bowed” legs. Muscle tightness or lack of flexibility in the gluteal (buttock) or quadriceps (thigh) muscles may increase the risk of IT band injuries. Sports physical therapists often use video tape analysis to uncover any biomechanical problems and make corrections in technique or muscle weakness or tightness.

How is IT Band Syndrome Treated?

Treating IT band friction syndrome generally includes:
R.I.C.E.: Rest, ice, compression and elevation is the best way to treat initial IT band pain.
Physical Therapy. A therapist may use ultrasound and other modalities to help the injured tissues heal more quickly. A skilled PT can also help you correct any biomechanical or training errors, and teach you how to perform the right flexibility exercises.
Biokinetics. For a biomechanical assessment and an individualized program to address specific instabilities and problems.
Reduced Activity. Runners with IT band pain should reduce running mileage and be alert for signs of overtraining syndrome.
Foam Roller Myofacial Release. Using a foam roller to release the tissues, may be painful, but many athletes have excellent success with this technique.
Anti-inflammatory medications may also be used to reduce pain and inflammation.
Rest and Recovery is an important part of your recovery and should be maintained as part of a balanced training program.
Hydrotherapy. Under the Supervision of your PT or Biokineticists
Will assist you to maintain your fitness levels and Rehabilitate in Non-weight bearing circumstances.

How to Prevent IT Band Syndrome
The following tips may help you prevent chronic IT band syndrome:

• If you are a runner, first review the Checklist for Running Overuse Injuries
• IT Band – Strengthening Exercises Strengthening the external hip rotators may also help reduce the risk of IT Band injuries. One simple way to do this is with the one-leg squat exercise. Perform these in front of a mirror and make sure your pelvis does not drop on one side during the reps.

◦      One-Leg Squat Exercise

• IT Band – Stretching Exercises Stretching the IT band may help prevent irritation from IT band tightness.

◦      Standing IT Band Stretch

◦      Advanced IT Band Stretch for IT Band Pain

◦      Crossover Squat Stretch

◦      Foam Roller Exercises to Stretch the IT Band

• Use the Right Shoes
• Consider Using Orthotics or Shoes Inserts
• Replace Running Shoes
• Avoid Overtraining
• Cross Train
• Get Adequate Rest and Recovery
• Try Backwards Running to correct muscle imbalance and reduce pressure on the knees.

• Run on a soft, level surface or alternate directions on the road.

IT Band Friction Syndrome doesn’t have to be a chronic, debilitating problem. A little bit of prevention and careful diagnosis of the cause can lead to a complete and full recovery.

Source: R Khaund, M.D. and S Flynn, M.D., Iliotibial Band Syndrome: A Common Source of Knee Pain, the American Academy of Family Physicians, April 15, 2005.