Understanding Iliotibial Band Syndrome

Also known as Runner’s Knee

Runners knee

The iliotibial band (IT Band) is a strip of tough, dense connective tissue on the outside of the thigh, running all the way from the hip to the knee. The iliotibial band plays an important role in stabilizing the knee and transferring force between the hip, knee, and lower leg. Under normal circumstances the iliotibial band will gently slide over the lateral femoral condyle (the end of the thigh bone that makes up the knee) as the knee flexes and extends. However, if the iliotibial band becomes tight it will rub too hard over the knee. If not addressed this will damage the iliotibial band, creating pain on the outside of the knee.

 

How Does IT Band Syndrome Occur?

Iliotibial band syndrome is an example of a repetitive strain injury. Unlike a traumatic injury which is caused abruptly following a trauma or accident, repetitive strain injuries are associated with very small amounts of tissue stress and damage called micro-trauma that accumulates slowly over time and cause pain. If the overload at the iliotibial band continues there will be ongoing micro-trauma and subsequent repair of this micro-trauma. Overtime, this scar tissue will build up and will start to interfere with the normal strength and flexibility of the iliotibial band and surrounding muscles.

Common symptoms include:

  • Pain on the outside of the knee
  • Pain can initially be dull or achy, but often becomes sharp and more severe in later stages
  • Pain is often worse with running or walking
  • In the early stages pain symptoms usually improve with warm-up or exercise
  • In later stages pain may worsen and be present during activity

 

Resolving Knee Pain From IT Band Syndrome

The proper treatment of iliotibial band syndrome must not only address pain and tissue damage at the iliotibial band and knee itself, but also correct any biomechanical problems at the foot and/or hip and pelvis. If muscle imbalances or joint dysfunction exist at the hip, pelvis or foot, knee pain is often the result. Addressing the adhesions, muscle imbalances, and joint dysfunction can be done in the following steps.

Step 1) Treat scar tissue adhesions and promote healing

Resolving scar tissue adhesions is a critical step in resolving knee pain, including iliotibial band syndrome.

These adhesions are a sign that the muscles are not healthy, and unhealthy tissue will not respond well to traditional stretches and exercises. One of the most effective methods for treating soft tissue adhesions is Active Release Technique. It is a hands-on treatment method that was specifically designed to identify and address scar tissue adhesions that are interfering with the normal movement of the body.

Step 2) Correct strength and flexibility

Treating the scar tissue adhesions will make the damaged tissue healthier, and will often result in a significant reduction in pain. In fact, it is not uncommon to see a significant improvement in just a few visits. However, although addressing the scar tissue makes the iliotibial band and surrounding muscles healthier, they may still be somewhat tight or weak. When this is the case specific stretches or exercises can be incorporated into a home exercise/rehabilitation routine to help support in office care. Initially the focus is on correcting local muscle deficiencies (i.e., at the knee, hip, or foot).

Step 3) Re-Train Functional Movement Patterns

The final stage with treatment is to ensure proper alignment and movement coordination of the foot, knee, hip, and trunk with functional movement patterns. This ensures movement of the hip, knee, and foot are coordinated and working together as a unit. This is what is required during real life activities such as running, walking, cycling, and climbing stairs.

 

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