WHAT IS ILIOTIBIAL (IT) BAND SYNDROME

Iliotibial Band Syndrome (ITBS) is one of the most common knee complaints among runners, short or long distance. ITBS is characterized by a burning stabbing sensation at the outside of the knee, worsened by high mileage, downhill running, or doing too much, too fast, too soon.

ITBS falls into the category of a ‘compressive syndrome’ as the pain and irritation come from the Iliotibial Band compressing against the lateral condyle of the femur. This is new information as just a few years ago, we believed it to be friction syndrome (science is great). The IT Band is essential for stability, strength, and movement. The band originates from the pelvis, is supported by the gluteus maximus and tensor fascia latae muscles, has attachment points along the femur to provide stability and prevent bending forces, and attaches to the lateral tibia just below the knee, further providing support to the knee joint as well.

The IT Band is strong, stretching less than 1% while under 9000 N of force; therefore, foam rolling or stretching the band itself is impossible. Trying to do so can be counterproductive to your return to running.

Common Causes of IT Band Syndrome

Lateral knee pain from IT Band compression can occur for multiple reasons, below are a few of the most common we see and address in our sports chiropractic clinic.

• Terrible Too’s: Too Much, Too Fast, Too Hard, Too Soon. A rapid increase in volume and intensity spells disaster for runners.

• Improper Biomechanics: Specifically hip adduction + knee internal rotation causing a valgus response (knee caving in).

• Tight or Weak Hip Musculature: Hip weakness is a common issue among runners and must be addressed with a structured rehab and strength training plan.

• Poor Warm-Up & Mobility: Many runners skip their warm-up and maybe stretch every other day. This needs to change.

• Lack Of Training Variety: The same shoes, distance, speed, and terrain. Try performing intervals, running on the trails, and alternating long and short runs. Variety helps!

How Do We Treat Iliotibial Band Syndrome:

ASSESSMENT: The first and most important step in treatment is a thorough evaluation and history. We must have an accurate diagnosis to formulate the best treatment plan for you and your goals. This also includes our 3-tiered running-specific evaluation that helps us guide you back to unrestricted pain-free running.

IN-OFFICE CARE: Our in-office care is made of 3 phases:

(1) Soft Tissue Care: This may include IASTM, Myofascial Work, Assisted Stretching, and Dry Needling. Our aim is to decrease muscle tension, sensitivity, and pain.

(2) Proper Joint Mobility & Movement Patterns: Joint manipulation is essential for proper movement through the running gait cycle. Restrictions in the foot, ankle, or hip can lead to compensation patterns and potential problems in the future.

(3) Corrective Exercise: Soft tissue work and joint manipulation will only have a temporary effect if they are not followed by corrective exercise. Our aim is ‘reprogram’ your movements and build strength to handle the stress of running.

HOME CARE: Home care will include regular mobility work on your problem areas, effective warm-up strategies to further progress your running, and strength exercises to continue rehab outside the office.

RETURN TO RUNNING: We would like to maintain some running while you progress through care. This may require a sharp decrease in volume and intensity at first but will stair-step back to your normal running as care progresses.

More videos to help you with Iliotibial Band Syndrome relief and get you back to running pain-free.