Identify Iliotibial Band Syndrome

Iliotibial Band Syndrome is otherwise known in the running community as any of the following commonly used references: ITB, ITBS, ITFBS or IT Band Syndrome. Who says runners don’t have their own language? ITB will commonly present as a dull ache and will often escalate to sharper pain on the outsides of your knees. ITBS can also present as pain in your ankles and, on occasion, the sides of your thighs just below hip level.

The pain along the outer sides of the knees is sometimes mistakenly referred to as ‘runners knee’ (see PFFS). However, PFFS is more commonly pain that presents directly behind the kneecap rather than along the outer sides of the knees as with iliotibial band syndrome.

Causes

Your IT bands are long tendons (strands of tough, tightly woven fibrous tissue that connect your muscles to your bones) that run along each side of your body from below the waist down to your ankles. Specifically, they attach to your pelvis and run down along the sides of your thighs muscles/knees and attach to the top of your tibia (lower leg bone). One of its main jobs is to provide your body with lateral leg support. That is, prevent you from tipping sideways during the ground strike phase of running while your body is only touching the ground with one foot.

There is some debate in the sport science community regarding the actual root cause of ITB. There is debate about the real cause being friction from rubbing against your bone joints or instead compression from surrounding muscle and fat tissue.

In any case, the result is inflammation and the goal of rehabilitation and future prevention lies in providing relief of constriction by keeping your IT band flexible and elongated.

So while ITB syndrome is definitely annoying and uncomfortable, it’s not usually a show stopper as far as running injuries go. Try running through the pain as you work towards the management and prevention strategies below.

Manage ITB

Perform regular fascia stripping by rolling a hard object (i.e. fascia roller, rolling pin, or wine bottle) down the sides of your legs all along your outer quads. Eventually work your way up to using body weight and roll yourself over the object. This is not only effective treatment for iliotibial band syndrome, but many other fascia tightness and pain points throughout your body like plantars fasciitis. Consequently, this feels fantastic on the sides of your lower back as well.

Get into the habit of regularly stretching after your runs with particular emphasis on ‘reach for the sky side stretch’. This is something you can conveniently do periodically throughout the day even at the office when you get up from your chair.

Finally, look at strengthening your adductor muscles that run along the insides of your thighs as these are likely a major contributing factor to your ITB pain if they are weak. There are several easy ways that you can strengthen these muscles without requiring access to a machine at a gym. One way is by putting a peanut butter jar or rolled up towel between your legs above your knees and performing many repetitions of squeezing. Make this more difficult and hit more running muscles by squeezing while doing the phantom chair against the wall.

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