What Is Iliotibial Band Friction Syndrome (ITBFS)?
The iliotibial band is a large band of fascia that extends from the outside margin of the pelvis, down the lateral (outside) leg attaching onto the top of the tibia in the lower leg. The IT band, along with the muscles that attach to it, functions to stabilize the knee and provide motion at the hip. ITBFS is an overuse type injury common in runners, athletes and individuals exposed to repetitive strain type motions in the work place. Pain typically results from repetitive compression of the fat pad that sits between the IT band and the lateral knee or from repetitive friction of the IT band where it crosses the knee. Factors that may contribute to its onset include sudden increases in volume or intensity of exercise, increase in running mileage, improper warm up before activity, muscular tightness or inflexibility, genu varum (bow-legged appearance at the knees), excessive pronation of the foot, among other sources.
What are the Symptoms of ITBFS?
Symptoms of Iliotibial Band Friction Syndrome are typically insolated to the lateral or outside portion of the knee and may include:
- Sharp pain or a dull ache which typically starts shortly after the onset of activity and may persist after stopping activity
- Muscular tightness
- Stiffness upon waking in the morning
- Pain while flexing the knee
Risk Factors & How to Avoid IT Band Pain?
Risk Factors to avoid Iliotibial Band Discomfort
- Too much, too soon, too fast
- Increase running mileage or training intensity too quickly can be a source of injury
- Poor running mechanics
- Activities with lateral (side-to-side) movement or sudden direction changes
- Poor fitting or worn out footwear
- Unsupportive footwear, such as sandals or poorly structured shoes
- Uneven terrain – avoid surfaces with uneven terrain like trails or loose gravel as they may place a greater strain on the involved tissues
- High impact and high volume or intensity of exercise
- Depending on your mechanics, being over weight or obese may increase the strain on the muscles and tendons in your lower legs
- Your mechanics – depending on your alignment and mechanics, you may be predisposed to IT band strain. Consult with your physiotherapist or Pedorthist if you suspect this may be the case
What are my options for treatment? Who else can help?
Your family physician typically serves as the first line of defense for treatment and will be able assist you with medications and life style alterations if appropriate, or to refer you to the right type of medical professional for further care. Physiotherapists and Kinesiologists may be appropriate to assist with exercises, stretches or lifestyle alterations; Pedorthists may be appropriate to control motions of the foot that may be impacting the strain place on the iliotibial band and associated tissues; Kinesiologists may assist with ergonomics (ensuring living environments and work stations are conductive to your posture and mechanics); massage therapists may be able to assist with muscular stiffness or discomfort. As you can see, there are a number of ways to address ITBFS. It is our hope that the information provided here will be enough to start your road to recovery!
Staying Active with IT Band Pain
Staying active while you recover is important for overall health and well-being. Appropriate exercise selection however, is important. As a general guideline, avoid any exercises or activities that induce or intensify your symptoms. That means both during and after the activity. With soft tissue injuries, once the tissue is warmed up it will often feel fine while active and the discomfort will set in once you stop the activity, after a period of rest, or may come the next morning when you get out of bed. If this is the case, reduce the intensity or duration of the activity until you reach a point that does not induce your symptoms. In particular, limit repetitive strain type activities such as running and cycling. While recovering, chose mild intensity exercises or cross training activities that will keep you active while helping to encourage a healthy recovery.