Iliotibial Band (ITB) Syndrome

Symptoms of iliotibial band syndrome are pain or aching on the outer side of the knee. This usually happens in the middle or at the end of a run. Factors contributing to this syndrome are weak hip abductor muscles, bow legs, pronation of the foot, leg length discrepancy, and running on a crowned (convex) surface. Circular track running may also contribute to this problem since it stresses the body in a manner similar to that of crowned surfaces and leg length differences.

Anatomy of the IT Band

All of these factors are aggravated by a tight iliotibial band. The iliotibial band is a thickening of the lateral (outer) soft tissue that envelops the leg. Changes in training (often sudden increases in mileage) frequently contribute to this problem. It is always important to examine your training regimen to see what alterations have recently occurred.

Treatment for ITB Syndrome

To self-treat this problem, you should:

  • Temporarily decrease training

  • Side stretch

  • Avoid crowned surfaces or too much running around a track

  • Shorten your stride

  • Wear more motion-control shoes to limit pronation

  • Strengthen your hip abductor muscles (gluteus medius muscle)

  • Carefully examine your training regimen (and running diary)

If your self-treatment is not completely successful, then a trip to a sports medicine specialist may result in either a steroid injection below the IT band or a recommendation for orthotics. Treatment is usually successful for this problem.

Side stretching is performed while standing as follows: Place your injured leg behind the good one. If the left side is the sore side, cross your left leg behind your right one. Then lean away from the injured side toward your right side. Lean on a table or chair for balance as you do this. Hold for 7–10 seconds, and repeat on each side 7–10 times. Be careful not to overstretch.

Hip abductor strengthening starts by standing on one leg with your other knee bent. You then tilt your hip and pelvis down and then lift them back up, keeping the knee straight on the leg on which you are standing.

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