Physiotherapist update: June 2019

Rina van der Merwe, Physiotherapist

ITB
(Iliotibial Band Syndrome)

Definition:

Ilio = from the iliacus (the
top and outside area of the pelvis) / Tibial
= to the tibia (bone in lower leg) / Band
= refers to the thin band of fascia that runs down the outside of the thigh.

                                        

One of the most common causes of knee problems in
runners.  It is an overuse injury.  The ITB starts at the top of the thigh from
the TFL (Tensor fasciae latae) and runs down the outside of the leg, over the
bony point of the outside of the thigh bone (femur), down over the outside of
the knee, where it attaches to the outside of the shin bone (tibia). This
tendon slides backwards and forwards across the thigh bone’s bony point every
time the knee bends and straightens.  The
repetitive sliding can create excess friction, especially when the knee is bent
at 30˚(which commonly happens
just as your foot strikes the ground in running). 

Causes:

*weak hip
muscles

*weak
quadriceps

*weak
core muscles

*poor
foot arch control

*worn
shoes

*sudden
increase in intensity, frequency, speed

*excessive hill training (up/down)

Symptoms:

*Gradual
onset. 

*Sharp or
burning pain on the outside of the knee area. 

*Pain
that worsens with continuance of running.

*Tenderness
and/or swelling over the outside of the knee. 

*Pain during early knee bending.

Treatment options:

*Diagnosis
of reason for symptoms (Physiotherapy assessment can help with this)

*Rest,
reduce pain and swelling

*De-loading
of ITB (taping or ITB band can help with this)

*Strengthen
weak muscles, stretch short muscles

*Address shoes and foot biomechanics