Iliotibial band (friction) syndrome very commonly affects the knee and is associated with especially running, cycling, hiking and weight-lifting.
The ITB is a thick band of fascia starting from the outside of the pelvis, running down over the hip, thigh and knee and inserting just below the knee. It is essential in knee stability during running but the rubbing motion from back to front over the lateral femoral epicondyle, combined with the flexion and extension motion at the knee joint tends to result in inflammation.
The symptoms commonly include a sharp, stabbing sensation just above the knee joint with possible swelling and thickening of the band. It can be painful during activity, often as the foot touches down, but the symptoms usually build over time. The pain may also be below the knee where the ITB attaches to the tibia and fibula.
All resisted knee extension activities should be avoided during recovery to promote healing.
ITB syndrome can be due to training habits, anatomical abnormalities or muscle imbalances. These include e.g. weak hip abductors or multifidi muscles, running on a cambered road, excessive up or down hills, “toed-in” position in cycling, leg rotation, foot supination or arch deviations from neutral - Its all greek until you understand how and why...
Your Physiotherapist can initially help you to relieve some of the inflammation by using the RICE principles, along with ultrasound and laser/light therapy. Once the inflammation is under control, the cause of the irritation needs to be addressed. Your training habits/schedule is the only thing that we won't deal with as directly. The arches of your feet, rotations in your legs and muscle imbalances can all be addressed by correcting the biomechanics of your movements. The use of strapping and compression bandages during the rehabilitation process will help to minimize the symptoms while you continue training.
A frequent, but very painful, self-treatment involves rolling back and forth over a foam roller. This is however rarely needed if the true cause of the problem is addressed adequately.
Steroid injections or surgical immobilisations are viable options to be considered carefully in severe cases only.
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