Iliotibial Band Syndrome often presents in runners and athletes as pain in the lateral aspect of the knee. The Iliotibial band (ITB) is a thin band of muscle travelling from the top of the pelvis (iliac crest) down past a bony protuberance on the outside of the knee. With use, the ITB slides over the bony protuberance at the knee, especially at 30 degrees of flexion, which can cause friction. Therefore repetitive flexion and extension of the knee, as with running and long distance walking can cause ITB syndrome.

Runners or walkers will usually have a slow onset of pain increasing with activity, presenting at the lateral knee and sometimes at the hip. The function of ITB is to extend and laterally rotate the hip, which happens with every footstep; hence this condition is usually an overuse injury caused by repetitive trauma rather then a single injury. People with ITB syndrome will generally have more pain walking downhill or when doing lots of hills. Initially the pain is tolerable but becomes more severe with further use.

There are several factors that can predispose a person to having ITB injury, these are important to be aware of, as they will play a major role in treating the problem. Some causes include:

– Muscular tightness of the TFL, glut max
– Excessive training or poor technique
– Muscular weakness of the glut med/min, inner thigh muscles
– Inadequate recovery/rehabilitation post injury
– Poor joint biomechanics of the hip/knee ankle
– Flat feet from excessive pronation (dropped arch)

Treatment of ITB syndrome requires different approaches. The first being physical treatment to release the tightness within the fascia of the ITB and other surrounding musculature while also correcting the biomechanics of the surrounding joints. Once this is underway, the patient will be given and exercise program with specific muscle releases and muscle strengthening work. One very effective technique is to release the ITB and surrounding muscles with a foam roller.

Commonly there is a weakness of the gluteal muscles, so strengthening exercises for the gluteals are important. ITB syndrome commonly responds well to conservative treatment, while some severe cases may require cortisone injections or even surgery.

If you would like more information or would like to book an appointment at Neurohealth Chiropractic – please call the clinic on 9905 9099 or email us or fill in the contact form from our website

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