Sunday, January 16, 2011

Iliotibial Band Friction Syndrome


The Iliotibial Band(ITB) is a tough group of fibers that run along the outside of the thigh. The gluteal muscles and the tensor fascia lata muscle attach to the top, and the lower part attaches to the tibia, just below the knee. It functions primarily as a stabilizer during running and can become irritated from overuse. Runners will usually describe pain on the outside part of the knee or lower thigh, often worsened by going up or down stairs, or getting out of a car.


Predisposing factors:

Training error: some runners make the mistake of only running on one side of the road. Most roads are higher in the center and slope off on either side. The foot that is on the outside part of the road is therefore lower than the other. This causes the pelvis to tilt to one side and stresses the IT band.

Abnormal biomechanics: the biomechanical abnormalities that may lead to IT band problems are, excessive pronation of the foot, leg length discrepancy, lateral pelvic tilt, and "bowed" legs. Tight gluteal or quadriceps muscles may also contribute. Video tape analysis is a great tool for uncovering biomechanical problems.


Side View
1. Place the right leg behind the left.
2. Bend at the waist, leaning over a support, such as a desk or counter.
3. As you bend the left knee, slide the right leg out away from your body. Keep the right knee straight.
4. Bend your body toward the right leg.
You should feel a stretch along the outside of the right thigh.

Front View
If you lean your upper body towards the leg you are stretching, then this will better stretch the IT band. In the example, the figure would bend (at the waist) to the right side of the screen. (the figure's left hand side)


Treatment:

  • Relative rest
  • Ice massage
  • Addressing any biomechanical or training errors
  • Gentle stretching: when doing the IT band stretch the "pulling" sensation is usually felt along the mid to upper thigh. Don't worry if this doesn't seem to exactly hit the site where the pain occurs. The IT band is a long structure and the goal is to get it to loosen and lengthen.
  • Gentle stretching of the gluteal muscles

Prevention of the IT band syndrome:
  • Run on a level surface or alternating directions on the road
  • A balanced approach to training which allows for rest and recovery
  • Preventive stretching
  • Strengthening the external hip rotators: this is achieved by doing sets of one leg squats in front of a mirror. Watch pelvic alignment to ensure that one side does not drop.
  • Orthotics
Source: Injury Clinic

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