The Iliotibial Band Friction Syndrome
Runner's Knee. A Common Cause of Lateral Knee Pain.
Oct 2, 2009
The iliotibial band is a thick band of fibre that starts at the top of the pelvis, then runs down the outside of the thigh to join onto the shin bone just below the knee.
When the knee is straight the iliotibial band lies behind the axis of movement of the knee joint. With the knee bent the iliotibial band lies in front of the axis of movement. Therefore every time the knee bends and straightens the iliotibial band makes a small movement backwards and forwards, over the outside lower part of the thighbone, each time moving over a prominence of bone that there is here.
With many hundreds of repetitions of bending and straightening the knee the iliotibial band can become inflamed and sore, this is what is called Iliotibial Band Friction Syndrome, often known as runner's knee.
The Symptoms of Iliotibial Band Friction Syndrome
Pain is the main symptom of iliotibial band friction syndrome. The pain is normally felt at the outside of the knee, just above the level of the knee joint line. Usually the pain is worse on any activity, typically when running, cycling or going up or down stairs, and disappears on rest.
The pain may be felt anywhere along the line of the Iliotibial band, so although it is most commonly felt at the outside of the knee, sometimes the pain occurs on the outside of the pelvis, or the outside of the thigh.
Treatments for Iliotibial Band Friction Syndrome
Physiotherapy/Physical therapy is the most effective form of treatment for Iliotibial Band Friction Syndrome. Treatment will usually consist of stretches and soft tissue release techniques to the iliotibial band. Stretching exercises may also be necessary to other muscle groups, for instance if the calf muscles are tight pronation increases at the foot, in turn increasing the strain on the iliotibial band. Strengthening exercises to particular muscle groups are important. Frequently in individuals with iliotibial band syndrome the glutei muscles are weak.
The local application of ice is useful to help with pain and reduce inflammation. Anti - inflammatory cream or tablets may also be used.
No amount of physiotherapy will cure iliotibial band syndrome if the underlying factors that caused it are still in place. A period of relative rest should be considered. On return to sport equipment and training techniques must be examined to prevent a recurrence of the symptoms. Four frequent training faults that contribute to Iliotibial Band Friction Syndrome are
- Incorrect running shoes that don't provide the correct amount or type of control at the foot for that individual.
- Cyclists who have their saddle too high.
- Track runners who only do anti-clockwise circuits on the track.
- Excessive pronation at the foot increases the strain at the iliotibial band. Pronation can be assessed by a podiatrist, and if necessary controlled with the use of orthotics.
If conservative treatments do not improve symptoms a cortico-steroid injection may be considered, iliiotibial band surgery is rarely indicated.
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