ILIOTIBIAL BAND FRICTION SYNDROME

Iliotibial Band Friction Syndrome

By Andries Lodder

As a Biokineticist, I know that one of the most commonly occurring injuries among athletes injuries is Iliotibial Band Friction Syndrome (ITBFS).

What is it really?

The ITB is the connective tissue band that runs down the lateral side of the thigh and attaches on the lateral surface of the tibial condyle (side of knee). The ITB originates from the Tensor Fascia Latae (TFL) muscle that originates on the side of the hip.  

ITBFS is an overuse injury that produces pain on the lateral knee during running and cycling. Pain is generally caused by an unusually tight ITB, the undersurface of which frictions over the lateral femoral condyle. This process leads to friction and inflammation causing the pain.

What causes it?

Typical causes include repeatedly running on the same side of a sloped road, anatomical problems such as bowed legs and differences in leg length or even excessive pronation (flat feet) of the foot and ankle. Lateral tilting of the pelvis and weak or tight gluteal or quadricep muscles are also common culprits.

How can I prevent it?
Make sure that you gradually increase your training load by no more than 10% each week. Alternate training in the form of core stability or cross training on rest days.

For a warm up you can start by stretching the Gluteus Medius and Tensor Fascia Latae muscles. This is very helpful as a preventative measure.

The type of foot wear is just as important. Foot type and motion has an effect so your shoe type needs to be correct. Increased pronation or supination can lead to increased tension in the ITB when running. Check the wear on your shoes and consider orthotics to control motion.

What treatments can I use?

Initial treatment. Because this is inflammatory in nature, ice packs are the effective treatment in the early stages. Apply ice packs to the knee for 15-20 minutes, 3-4 times a day.

Orthotics. Critical to long term resolution is to have an assessment of your posture and lower limb alignment. A correction of a leg length discrepancy is highly effective and can be combined with a foot orthotic to correct either supination or pronation.

Foam rollers. Use a foam roller to roll the outer side of the leg to massage the ITB and surrounding muscles. Specific stretching and strengthening exercises are crucial in treating the underlying cause of the problem. Use the roller against muscle knots with your own body weight to generate pressure.