43 Thames Street, St Albans, Christchurch 8013 Phone: (03) 356 1353. Website: philip-bayliss.com Iliotibial Band Syndrome (ITB) Knee pain and knee injuries, as a result of Iliotibial Band Syndrome, can be an extremely painful and frustrating injury that puts a big strain on both the knee and hip joints. Knee injuries are very common among runners and cyclists. However, they don't usually occur in an instant, like a hamstring strain or groin pull, but commonly start off as a twinge or niggle, and progress quickly to a debilitating sports injury that can sideline the best of us for weeks. What is Iliotibial Band Syndrome? For those who aren't familiar with Iliotibial Band Syndrome, let's start by having a look at the muscle responsible for the problem. The iliotibial band is actually a thick tendon-like portion of another muscle called the tensor fasciae latae. This band passes down the outside of the thigh and inserts just below the knee. The diagram to the right shows the anterior (front) view of the right thigh muscles. If you look towards the top left of the diagram, you'll see the tensor fasciae latae muscle. Follow the tendon of this muscle down and you'll see that it runs all the way to the knee. This thick band of tendon is the iliotibial band. Or iliotibial tract, as it is labelled in the diagram.
The main problem occurs when the tensor fasciae latae muscle and iliotibial band become tight. This causes the tendon to pull the knee joint out of alignment and rub against the outside of the knee, which results in inflammation and pain. What Causes Iliotibial Band Syndrome? There are two main causes of knee pain associated with iliotibial band syndrome. The first is "overload" and the second is "biomechanical errors." Overload is common with sports that require a lot of running or weight bearing activity. This is why ITB is commonly a runner's injury. When the tensor fasciae latae muscle and iliotibial band become fatigued and overloaded, they lose their ability to adequately stabilize the entire leg. This in-turn places stress on the knee joint, which results in pain and damage to the structures that make up the knee joint. Overload on the ITB can be caused by a number of things. They include: Exercising on hard surfaces, like concrete; Exercising on uneven ground; Beginning an exercise program after a long lay-off period; Increasing exercise intensity or duration too quickly; Exercising in worn out or ill-fitting shoes; and Excessive uphill or downhill running. Biomechanical errors include: Leg length differences; Tight, stiff muscles in the leg; Muscle imbalances; Foot structure problems such as flat feet; and Gait, or running style problems such as pronation. Exercises All photos below assume that it is the right leg that is the injured leg. Repeat all stretches 3-5 times, 3 different times a day. With all these stretches you may feel it more up near the hip as opposed to down lower where you may be experiencing pain; this is normal.
Stretch #1: Pull foot up to back of buttocks. Cross the uninjured leg over the injured leg and push down, hold for 30 seconds. Stretch #2: Cross injured leg behind and lean towards the uninjured side. This stretch is best performed with arms over the head, creating a "bow" from ankle to hand on the injured side (unlike how it is depicted).
Stretch # 3: Cross injured leg over the uninjured side and pull the leg as close to your chest as possible. Foam Roller (left and below): Roll your injured leg over the foam roller, add more time gradually each day to help mobilize your tissues and break up scar tissue.
Balance on 1 Leg Strengthening (left and below): May start just balancing on one foot when brushing your teeth. Gradually you can add challenges such as using a soccer ball and moving the ball in different directions. Another good method is to balance on one foot and play catch with yourself with a tennis ball against a wall or dribble a basketball. Start out with one minute at a time, and build up to 3-5 minutes.
Side Leg Lifts: Keep the back of the leg and buttocks against the wall. Slide the leg up the wall and hold at the top for 5 seconds then slide back down. Point toes down. Start with one set of 20 each leg, after 1 week add a second set of 5. Every 2 days add 5 more as long as it is being well tolerated until you build up to 3 sets of 20 lifts. Strengthening with Theraband (left and below): Loop one end and close in the door. Loop other end around the uninjured leg. Bend your knee on the injured leg and balance on the injured leg. Put your uninjured leg through a range of running motion, going up and back. Build up to 3-5 minutes, make sure to exercise both legs.