Iliotibial Band Syndrome (I-T Band Syndrome)

Sometimes spelled Ileotibial, this syndrome is simply a pain on the outside of the knee. Except that the pain may show itself anywhere up to the hip. The pain usually increases gradually on a run; it may cease afterwards.
Many runners experience soreness and tightness on the outside of their thighs and quadriceps, but are unaware of what is actually going on in their body. The soreness they feel is not in their muscles at all, but actually in a tissue called the Illiotibital Band (ITB). The leg muscles are surrounded by a thin soft tissue called a fascia. Toward the outside of the leg, this tissue becomes very thick and forms a band which runs from your knee to your hip. At the lower end it is connected to your tibia, while on top it is connected to your gluteus maximus and tensor fascia lata (front and rear hip muscles).
The pain associated with ITB syndrome are caused mostly by the wear and tear of extended amounts of running. Most commonly pain is felt towards the middle or end of a run when the band has already endured some stress. The outside of the knee is where the most irritation is usually felt because the band is rubbing against the lower end of your femur (thigh bone). General aching in the outside portions of the legs and *dead legs* at the end of runs are also signs that you might have an ITB problem.
The cause of ITB syndrome, other than simple overuse, is often an imbalance either in the runner or the running surface. If you are constantly running on a track and leaning into the turns, one leg endures more stress than the other, which causes problems in the ITB. The same leaning can be generated by running on a crowned road, where one foot lands slightly higher up on the crown than the other. This forces your legs to act as if the are different lengths, adding extra stress to your body.

Cause of ITB Syndrome

This strong band goes from the muscle at the outside and front of the pelvis (tensor facia latae muscle), down the thigh to insert at the shin, where it passes by the knee, cushioning small sacs of fluid stop it rubbing against the bone. The sacs or the band may become inflamed – typically by:

    • running down hills.
    • a change in surface or training.
    • excessive foot movements.
    • running on cambered surfaces.
    • bow legs.
    • overpronation.
    • worn out shoes.
    • worn out body–(overtraining) tightness in the band.
    • unequal quad strength, or leg length differences predispose you to ITB syndrome.


Prevention of ITB Syndrome

    • Make changes in the type of training slowly.
    • Avoid hill reps on a camber.
    • avoid tight bends. Do the ITB stretches and stretch the other major muscles.
    • Strengthen the weak quad with straight leg raises and leg extensions.
    • Podiatrist to check if a special insert for the shoes would help.


Treatment of ITB Syndrome

    • Attack the cause, but back off the mileage and take anti-inflammatory drugs.
    • ICE it often.
    • Cortisone may help relieve the bursa; or the inflamed area can be removed.
    • To decrease both types of knee insult, don’t do stair climbing in rehab.
    • Remember the top end of the band–It can cause problems, too.

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