Iliotibial Band (IT Band) Friction Syndrome

Iliotibial Band (IT Band) Friction Syndrome

Iliotibial Band Syndrome is a common injury amongst runners and tri-athletes. The Iliotibial band is a tough group of fibers that run on the outside of the leg. It begins at the hip and runs down the leg to the knee. The gluteal and tensor fascia lata muscles attach to the top of the IT Band. The band ends on the outside part of the knee, on the tibia. The IT band serves to act as a knee stabilizer during running. Through repetition and overuse, the IT band can become irritated and inflamed. Runners will usually describe a pain on the outside of the knee or lower thigh that gets worse while going up or down stairs, or when getting up from a seated position.
When starting to run, the IT band may hurt initially and then may stop during the run, but then will quickly return after resting. As IT band syndrome worsens, the intensity of the pain and frequency will increase. Eventually, the pain will not decrease during running and swelling may be visibly noticed around the knee. Usually, affected people have a very tender spot on the outside of the knee.

Causes of Iliotibial Band (IT band) Syndrome
The Iliotibial band is a stabilizer of the knee. It prevents excessive side-to-side motion during running or walking. When the knee moves side-to-side while running, it will place increased stress on the IT band. Frequently, running on one side of the road will increase the stress on the IT band and therefore the likelihood of developing IT band syndrome. When the pelvis is tipped to the side-as it is when running on a street that it cambered--the IT band is stressed. Additionally, biomechanical abnormalities or altered running gates may lead to IT band problems, such as excessive foot pronation, leg length discrepancy, lateral pelvic tilt, bowed legs, or muscle imbalances. Tight gluteal or quadricep muscles will also affect the IT bands movement and will place increased stress on the tendons.
People who have chronic IT Band Syndrome injuries may have a combination of muscle imbalance or altered biomechanics that increase the risk of developing IT band syndrome. Your health provider will be able to determine the cause of your IT Band Syndrome.

Home Treatment for Iliotibial Band Syndrome
Home treatments for IT Band Syndrome include rest, ice, stretching, and footwear modifications. Icing the inflamed IT Band will reduce the inflammation and speed recovery. As the IT becomes irritated with every step, ice will reduce the inflammation that develops daily or after running. Stretching the hip, IT band, quadriceps, and hamstrings is important to reduce the stress on the knee. Also, proper running shoes can make a significant difference at reducing stress on the IT band. Not all running shoes are created equal; some shoes are designed to reduce overpronation of the foot. A runner who has excessive overpronation may benefit from a shoe specifically designed to limit this excessive pronation. Specialty running stores will watch you stand and run, and will expertly recommend a shoe that works best for your level of pronation.

Office Treatment for Iliotibial Band Syndrome
Seeking treatment for IT band Syndrome may be required if the pain continues for two weeks or continues to worsen. Office treatments will focus on decreasing the inflammation and pain at the IT band tendon. Electric therapy, ultrasound, and ice may be used. Further treatment will consist of identifying tight muscles and specifically stretching those muscles to reduce the tension on the IT band. Your provider will also identify weak muscles that are contributing to the stress on the tendon. Strengthening exercises will isolate the weakness and reduce the lateral movement of the knee or pelvis. Orthotics may be considered in some situations to reduce foot pronation.

Massage therapy or manual therapy will be utilized to decrease muscle spasms in affected areas. Attention will be paid to gluteal, hip, quadriceps, hamstring, and the lower leg muscles, as all of these muscles can be affected during IT band injuries. The Graston Technique may be used, which will break up the scar tissue that develops with Iliotibial band injuries. The Graston Technique will speed the healing and recovery in IT band syndrome. With proper treatment, many runners may continue running during treatment and may not have to stop running. This technique should be considered with anyone who has had several episodes of IT Band Syndrome which returns after several months.

Prevention of Iliotibial Band Syndrome
Prevention of IT band injury requires a combination of reducing stress to the IT band, proper footwear, and smart training. Running on level surfaces or alternating directions on the road will help reduce the stress to the IT band. Training that alternates running on the road, canals, or trails will reduce the likelihood over overuse injuries. A balanced training program that promotes proper amounts of running, strengthening, stretching and rest will likewise reduce many IT band injuries.
If you suspect that you are suffering from Iliotibial Band Syndrome, quickly take steps to reduce the stress on the tendon. Waiting for the pain to increase will produce a more severe injury that will require more treatment. If an injury fails to resolve quickly, seek care from an experienced provider who can keep you running while taking all of the steps necessary to resolve your IT band injury. Call Alpha Chiropractic today at (480) 812-1800.

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Dr. Carson Robertson is in private practice at Alpha Chiropractic. His clinic services the chiropractic, massage therapy, and physiotherapy needs of the Chandler, Ahwatukee, and Gilbert area. He has a special interest in athletics, running, and soft tissue injuries. Carson Robertson DC can be reached at (480) 812-1800.