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ITB Pain: Ilio-Tibial Band Syndrome ๐Ÿƒโ€โ™€๏ธ๐Ÿƒ

The Iliotibial Band (ITB) is a thickened band of connective tissue running from your pelvis to the outside of your knee. It is an incredibly strong and resilient structure โ€“ one of the strongest in the human body!

However, it can cause discomfort on the outside portion of your knee. Runners; endurance athletes and cyclists often experience discomfort due to ITB related pain. It is an overuse injury meaning the ITB is placed under more load than it can handle; this can be caused by a number of factors.

But, first what is the mechanism behind this pain or discomfort? The below diagram illustrates.

ITB Pain Mechanism

Causes of ITB Related Pain

1. Muscle Weakness and Fatigue: The gluteal muscles (Glute Max, Med and Min) are responsible for limiting the inward rotation of the femur. Weakness of these muscles will increase the amount of inward rotation of the femur resulting in the ITB working overtime to stop this rotation.

2. Training Errors: As outlined in the pie chart. A spike in duration; frequency; distance or intensity of your runs can quickly lead to ITB related pain. Uneven terrain; ill-fitting shoes or a spike in hill training can also contribute toward ITB Syndrome.

3. Running Pattern: A narrow running gait, as shown on the right, means the ITB is placed under more strain and therefore further compresses the underlying connective tissue onto the bone.

Signs and Symptoms of ITB Syndrome

  • Sharp pain on outer aspect of knee.

  • Walking downstairs or downhill running aggravates pain.

  • Long distance running/cycling aggravates pain.

  • Tenderness on outer aspect of knee with palpation.

What Works and What Doesnโ€™t? โœ… โŒ

โœ…Strengthening Exercises: Consistent strengthening of the entire kinetic lower limb chain is recommended for endurance athletes, but focus should be emphasized on strengthening gluteal muscles.

โœ…Dry Needling: Often trigger points will develop in muscles implicated with ITB related pain. Dry needling aimed at these trigger points will reduce muscle tension on the ITB.

โœ…Strapping: Offloading the ITB and underlying tissue with the use of strapping will assist in bringing your pain down dramatically.

โœ…Shockwave Therapy: At CMP Inc we offer Extracorporeal Shockwave Therapy with many of our patients having great success with this form of treatment.<