Iliotibial Band Syndrome (ITBS)
If you’ve ever walked Vancouver’s seawall, you would know that running is a popular exercise. There are plenty of benefits of running, such as increasing your cardiovascular capacity to strengthening your muscles and joints. However, it’s also a very common cause of injury due to its repetitive nature. The knee is the most common site for running related pains. A particularly common running knee injury is Iliotibial Band Syndrome (ITBS).
ITBS is a repetitive strain condition caused by excessive friction of the iliotibial (IT) band at the lateral side of the knee. The IT band is a long and thick tendon that runs down the lateral thigh. When the knee bends and straightens, the IT band naturally rubs or rolls over the outside of the knee. So with enough repetition, the excessive rubbing of the IT band can lead to pain and inflammation.
As with all overuse injuries, the trick to ITBS prevention is to identify your risk factors. There are a large number of possible causes, but thankfully most of them can be fixed or improved once identified. In general, there are three categories of risk factors – 1. anatomical alignment, 2. muscle imbalance, and 3. training errors.
1. Anatomical Alignment
- High arches or flat feet
- Excessive pronators
- Bow-legged in the knees
- Inherent tightness of the IT band
- Pregnancy or post-partum
2. Muscle Imbalance
- Weak hip abductors, especially the gluteal muscles
- Weak core
- Weak intrinsic foot muscles
- Tight hip adductors, especially the groin muscles
3. Training Errors
- Improper footwear or worn out shoes
- Running on a constant surfaces - like banked surface of roads, running on a track, or running on a treadmill
- Excessive hill running especially downhill
- Excessive mileage or a sudden increase in mileage when training
Some of these risk factors are easy to identify and some are a little trickier. Having a biomechanical assessment by a physiotherapist can not only help identify your risk factors, but also provide you both an exercise regimen and a graduated running program.
But if you’ve already developed ITBS, then stop running and seek treatment. If your IT band is already inflamed from running, continuing to run will further aggravate the condition.
Core and gluteal strengthening is key to ITBS prevention and treatment. For acute stages of ITBS, the focus is on hip strengthening exercises such as hip abduction and hip extension motions. For those who have minimal pain or are looking for ITBS prevention, closed kinetic chain exercises such as squats, split squats, plank and bridging are great for both glutes and core strengthening.
As a concluding note, remember that running is not supposed be painful. Being a better “listener” to your body will help runners go a long way, in distance and in health!