Physiotherapist update: June 2019


Rina van der Merwe, Physiotherapist

ITB (Iliotibial Band Syndrome)

Definition:
Ilio = from the iliacus (the top and outside area of the pelvis) / Tibial = to the tibia (bone in lower leg) / Band = refers to the thin band of fascia that runs down the outside of the thigh.
                                        
One of the most common causes of knee problems in runners.  It is an overuse injury.  The ITB starts at the top of the thigh from the TFL (Tensor fasciae latae) and runs down the outside of the leg, over the bony point of the outside of the thigh bone (femur), down over the outside of the knee, where it attaches to the outside of the shin bone (tibia). This tendon slides backwards and forwards across the thigh bone’s bony point every time the knee bends and straightens.  The repetitive sliding can create excess friction, especially when the knee is bent at 30˚(which commonly happens just as your foot strikes the ground in running). 
Causes:
*weak hip muscles
*weak quadriceps
*weak core muscles
*poor foot arch control
*worn shoes
*sudden increase in intensity, frequency, speed
*excessive hill training (up/down)
Symptoms:
*Gradual onset. 
*Sharp or burning pain on the outside of the knee area. 
*Pain that worsens with continuance of running.
*Tenderness and/or swelling over the outside of the knee. 
*Pain during early knee bending.
Treatment options:
*Diagnosis of reason for symptoms (Physiotherapy assessment can help with this)
*Rest, reduce pain and swelling
*De-loading of ITB (taping or ITB band can help with this)
*Strengthen weak muscles, stretch short muscles
*Address shoes and foot biomechanics