Iliotibial Band Syndrome (ITBS)

With proper diagnosis and treatment then Iliotibial Band Syndrome (ITBS or ITBFS, for Iliotibial Band Friction Syndrome) can normally be effectively managed although recovery may take some time.

The iliotibial band (ITB) is a strip of connective tissue on the lateral side of the thigh, which extends from the outer part of the pelvis, over the hip and knee, and connects into the lower leg with an insertion just below the knee.

During running the ITB assists in stabilising the knee as it moves from behind the femur to the fore during each stride. There can be constant rubbing of the ITB over the lateral femoral epicondyle (the bump on the side of the thigh just above the knee) which when combined with repetitious bending and straightening of the knee during running may cause the iliotibial band to become irritated or inflamed.

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Iliotibial Band Syndrome symptoms vary from a sharp sensation just above the knee joint to inflammation or thickening of the tissue at the point where the ITB moves across the femur. It is not uncommon that any pain is not immediately present during activity, but can increase over time, especially when the foot impacts the ground. Pain can sometimes occur below the knee, where the band joins to the tibia. Occasionally Iliotibial Band Syndrome can also occur where the ITB attaches to the hip, though this is less common as a sports injury. This occurs frequently during pregnancy as the Relaxin hormone loosens connective tissue whilst the mum-to-be gains weight.

There are a number of factors that contribute to the occurrence of Iliotibial Band Sydnrome. These include:

• Running on the camber of a road can bends the downhill leg inward and cause stretching of the ITB whilst rubbing against the femur
• Substantially increasing running distance in a short period of time
• Insufficient warm-up (r cool-down )
• Too much downhill running or running up and down stairs
• Abnormalities in the anatomy and the legs and feet.

Treatment
As with any injury, you should consult your health care practitioner for diagnosis and for recommended treatment plan.

Treatment generally requires modification to activity, massage, and stretching of the ITB and strengthening of the affected limb. The objective is to reduce any friction of the ITB as it glides over the femur. Most runners with low mileage respond well to of anti-inflammatory medicines and stretching; however, runners who are used to doing a high-mileage often require a treatment program that is somewhat more comprehensive.

The initial goal should be to reduce the impact of inflammation by using ice and anti-inflammatory medications. Activities that requires repeated bending and straightening of the knee should be avoided. After the immediate sypmtons have settled down a runner with acute ITBS should consider reducing weekly running distance by about 50% for a couple of weeks, (only running on the flat). If there is no reoccurrence of pain then can slowly begin to increase distance. If ITBS pain returns then you should stop running immediately for a minimum of 2 weeks. If the pain and inflammation are still there then another month of rest is recommended. One common trick for reducing the risk of the problem reoccuring is to change your running route as a frequently traversed route may place increased stresses on the ITB of a particular leg.

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