Overview

The iliotibial band is a tendon that begins at the pelvis and runs down the outside of the thigh and crosses through the knee to attach to the shinbone. It serves to stabilise the outside of the knee as it flexes and extends during movement.

ITBS refers to inflammation of this tendon as it slides back and forth over its connection point at the outside of the knee. Although this movement is part of the normal range of motion for the knee and tendon, repetitive sliding and overuse of the tendon through repeated bending and straightening causes friction and irritation.

Causes

Some of the most common causes of ITBS include:

  • Overuse and repetitive strain caused by increasing the distances you run or your general training intensity.
  • Inward rolling of the knees and hips during running.
  • Worn out, damaged, inappropriate or unsupportive footwear.
  • Downhill running or running on uneven surfaces.
  • Weak gluteal muscles, hip muscles and hip rotators.
  • Difference in leg length, bowed legs, abnormal pelvic tilt and flat feet.

Symptoms

There are varying degrees of ITBS. Depending on the severity, you may experience one or more of the following symptoms:

  • An ache or burning pain outside the knee and occasionally outside of the thigh and hip joint.
  • Pain in the above areas that increases during running or other repetitive movements and improves with rest.
  • Swelling at the outside of the affected knee.
  • Limping after exercise or periods of repetitive activity.

Diagnosis

To determine whether you are suffering from ITBS, Dan Everson Podiatry will ask questions about your symptoms and health history. A careful physical examination of your posture and body and limb movement when walking will assist diagnosis. In some cases it may be necessary to send you for an ultrasound or MRI.

Treatment

With adequate treatment and care most cases of ITBS can be resolved within 6 weeks to 6 months.

There are simple measures that can relieve symptoms of ITBS such as rest, icing the affected area on the knee and regular stretching. Depending on the effectiveness of these, it may be necessary to undertake one or more of the following treatments:

  • Use pain-relief and anti-inflammatory medication.
  • Review and modify your training program to avoid excessive or repetitive running movements and activities.
  • Strengthening of the knee, hip and leg muscles.
  • Correct your running and landing technique.
  • If you have a gait imbalance, Kinetic Orthotics may be prescribed and inserted into your footwear to help balance weight loading in the foot and guide motion of the foot during walking and running.

Prevention

Dan Everson Podiatry recommends the following steps to help prevent ITBS:

  • Avoid running on hard surfaces such as concrete or bitumen.
  • If running on the road, change direction often so that both legs are exposed equally to inconsistencies in the road.
  • Gradually increase your running distance and intensity. Avoid sudden and drastic increases to mileage and effort.
  • Ensure your shoes or joggers are not damaged or worn and distribute your weight evenly across the foot.
  • Schedule an appointment with your podiatrist to ensure you have appropriate footwear for your needs.
  • Orthotics may be prescribed to help prevent an occurrence of ITBS in those at risk.
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