The recent good weather, with plentiful sunshine and long evenings has lead to a dramatic increase in the numbers out running. While it’s fantastic in terms of people’s general health, there has been an associated increase in runners presenting to the clinic with running related injuries, particularly so in the last week leading up to the Connemarathon 2012 over West and the Gaelforce Greystones to Bray 10k here in the East. In particular I’ve seen a lot of runners presenting with Iliotibial band (ITB) syndrome.
I thought it would be useful in today’s post to explain a little about this common running injury and how best to remedy the condition should it occur.
The iliotibial band (ITB) is a thick fibrous band of tissue that runs down the side of the upper thigh. It’s joined to the Tensor Fascia Latae (TFL) muscle near the hip and joins the side of the knee attaching to the fibula, tibia and the patella. The ITB being a thick fibrous band of non-contractile tissue is prone to tightening due to training errors, excessive training or biomechanical abnormalities.
ITB syndrome occurs when the ITB has tightened to such an extent that it no longer glides smoothly over the lateral epicondyle of the femur (bony prominence above your knee joint). The friction caused by the tightened ITB as it rubs forwards and backwards across the lateral epicondyle produces pain and discomfort felt on the outer aspect of the knee joint. Sufferers of ITB syndrome can often predict accurately at what stage into their run the symptoms will come on. (Eg. always after 5 km or after 20 minutes).
Accurate diagnosis of ITB syndrome is essential as there are many other conditions which may cause lateral knee pain. Damaged lateral meniscus of the knee is just one example. Once, accurately diagnosed by a Chartered Physiotherapist, and having ruled out any other potential causes of your knee pain, treatment may include:
- Myofascial Release of the ITB
- Dry Needling of the ITB
- Possible dry needling of gluteal trigger points
- Hip strengthening
- Tensor Fascia Latae (TFL) stretching
- Foam Rolling of ITB
- Avoidance of downhill running.
An ongoing programme of foam rolling and stretching will be essential to any athlete’s successful sustained recovery from ITB syndrome. A full biomechanical analysis of athletes running may be warranted in persistent cases of the condition.