Iliotibial Band Syndrome

Explaining ITBS

What is Iliotibial Band Syndrome (ITBS)?

If you’re an active person who enjoys running or other sports, and you’re facing chronic pain on the external side of the knee, you may be dealing with iliotibial band syndrome (sometimes called Runner’s Knee).  This condition requires a medical grade IT Band Treatment to alleviate and prevent pain.

The knee joint is a complex of muscles, tendons and cartilage that must all work in unison to support and move the leg properly. Overuse injuries (such as patellar tendinitis or bursitis of the knee), as well as the effects of aging (like arthritis, gout, and deterioration of the cartilage) can all play a part in bringing on chronic knee pain, but the most common cause is the strain and impact caused by running.

The individuals most prone to develop iliotibial band syndrome (ITBS) are athletes.  Most prone are those involved in sports that require a lot of running, like soccer or track and field events. Hence, the condition’s common name, Runner’s Knee.

While many of the causes and risk factors involved in iliotibial band syndrome are similar to the equally common patellofemoral pain syndrome, and while both conditions are commonly referred to as “runner’s knee” there is a marked difference between the two.

Specifically, patellofemoral pain syndrome results in progressive pain that forms in the front of the knee, behind and surrounding the patella (knee cap). Iliotibial band syndrome, on the other hand, results in pain along the outer side of the knee at the point where the iliotibial band connects to the end of the tibia (shin bone) and the patella.

But you don’t have to be an athlete to deal with this common cause of chronic knee pain.

Iliotibial Band Syndrome Symptoms

  • Progressively worsening pain along the outer side of the knee, usually starting 5-7 minutes into a run

  • Rarely, swelling or redness in that area. (If swelling occurs, you may need to see a doctor to help you diagnose whether your issue is ITBS or a lateral miniscus tear.)

It’s normal for runners and other active people to deal with soreness and pain in muscles and joints for a day or more after an intense workout. But chronic pain that starts at the workout and gets progressively worse is likely a sign of injury or a chronic inflammation.

Iliotibial band syndrome is an inflammation of the iliotibial band (a large tendon that connects the hip to the knee) that involves pain along the side of the knee joint, usually beginning after a particularly strenuous period of exercise. But, unlike standard next-day soreness, this knee pain eventually progresses to the point of interfering with everyday activities such as walking and going up or down stairs. It can even cause pain when the knee is stationary in a bent position (such as while sitting at a desk or on the couch.)

Iliotibial Band Syndrome Causes and Risk Factors

  • Consistent over exertion
  • Poorly balanced muscle development
  • Poor running form
  • Inflexibility (especially of the gluteus maximus and quadriceps)
  • Overpronation, underpronation, or flat feet
  • Congenital hip/ankle/knee imbalances

While ITBS feels and acts like tendonitis, it actually is not technically an inflammation of the tendon due to tearing. Rather, it is an inflammation caused by the tendon rubbing against the bone repeatedly as the knee is flexed and turned inward.

Damage can be done due to a number of reasons, some of which are out of our control. For instance, women are more likely to develop ITBS because the relative shape and position of their hips tends to produce more stress on the knee joint when running than a man’s. Other congenital imbalances or shaping of the hip, ankle, or knee joints can cause similar undue stress on the knee, making this form of runner’s knee more likely.

Similarly, those with conditions involving the structure of the foot, such as overpronation (a tendency to run on the inside of the bottom of the foot), underpronation (running on the outside of the bottom of the foot), flat feet or fallen arches, will inadvertently place additional stress on the knee joint during use.

More so than other common types of knee pain, running form and stride length have a large bearing on an individual’s chances of developing ITBS since the main cause is one of exaggerated movement at the outside of the joint, which can be lessened or eliminated by improving one’s form.

By far the most common cause of iliotibial band syndrome, however, is simple overuse due to the stress and impact caused by running.

Iliotibial Band Syndrome - IT Band Treatment

Relieving the pain caused by iliotibial band syndrome requires that you:

  • Reduce the inflammation
  • Lessen or eliminate the causes of knee joint stress
  • Support the IT band and knee structure during activity

If you can accomplish those three goals, you should note pain relief very quickly.

Doctors treating runner’s knee will recommend the following options for accomplishing this:

  • Rest – Get off your feet as much as possible when the pain is at its worst. If you must walk or run, keep in mind that any activity that requires bending the knee will result in pain, especially walking downhill or down stairs.To keep up cardiovascular health during the recovery period, low-impact activities like swimming or rowing should be substituted for running or cycling.
  • Ice – Use ice on the side of the knee immediately after exercise and (if necessary) several times a day to help reduce swelling.
  • OTC Pain Relievers – Take Motrin, Advil, or other over-the-counter pain relievers that contain ibuprofen or naproxen to help lessen the inflammation and ease pain.
  • Stretches – Stretch your IT band, thighs, hips and buttocks repeatedly before, during, and after exercise to keep the muscles and tendons limber.
  • Strengthening – Once the initial recovery is underway, strength training focused on balanced conditioning of the knee joint and surrounding muscles will help stabilize and strengthen the entire structure. Improved strength in the core and buttocks also helps prevent a recurrence of ITBS.
  • Compression Knee Product – Purchase a knee brace or other knee stabilizing support that will apply medical grade pressure to the joint during activity, reducing strain and allowing it to heal while easing pain.
  • Cortisone – If none of the above helps, your doctor may prescribe regular injections of cortisone to control the pain, although this would be rarely used since corticosteroids tend to weaken tendons and can increase the chances of further complications.
  • Surgery – As a last resort, your doctor may attempt surgery to repair the knee.

PLEASE NOTE: While some or all of these options may be effective in temporarily easing the pain of plantar fasciitis, they can also be difficult, costly, uncomfortable, and even dangerous!

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