If you’ve got a nagging pain on the outer part of your knee, especially if you’re a runner, it could be a symptom of Iliotibial Band (IT band) syndrome. It’s an injury often caused by activities where you bend your knee repeatedly, like running, cycling, hiking, walking long distances.
Your IT band is a thick bunch of fibers that runs from the outside of your hips to the outside of your thigh and knee down to the top of your shinbone. If your IT band gets too tight, it can lead to swelling and pain around your knee.
IT band syndrome usually gets better with time and treatment. You don’t typically need surgery.
What causes IT band syndrome?
Your iliotibial band gets irritated and swollen when it’s stretched too tight and rubs against bone. Possible causes of a tight iliotibial band include:
- Excessive foot pronation: Your foot naturally rotates outward. That stretches the iliotibial band and brings it closer to your bones.
- Hip abductor weakness: Abduction of the hip is when your hip turns away from your body. A weakened ability to rotate your hip might cause your iliotibial band to tense.
- Internal tibial torsion: Your tibia is also called your shinbone. Internal tibial torsion is when your tibia is twisted inward toward your body. This pulls your iliotibial band closer to your bones.
- Medial compartment arthritis leading to genu varum: Medial compartment arthritis happens in your knee joint. Genu varum causes your knees to spread when your feet touch your ankles. This pulls on your iliotibial band, tightening it.
- Preexisting iliotibial band tightness: It’s possible that you just happened to be born with a tighter iliotibial band.
What are the symptoms of IT band syndrome?
A tense iliotibial band can cause several symptoms:
- Hip pain: Your iliotibial band repeatedly rubs against your greater trochanteric in your hip. Your greater trochanteric is where the bone widens near the top of your femur. The friction causes inflammation in your tendon and pain in your hip. You might hear a snapping sound.
- Clicking sensations: You might feel a snap, pop or click on the outside of your knee.
- Knee pain: Your lateral epicondyle is on the outside of your knee near the bottom of your femur, where the bone widens. Your tense iliotibial band repeatedly rubs against your lateral epicondyle when you flex and extend your knee. The friction causes inflammation in your tendon and pain in your knee.
- Warmth and redness: The outside of your knee might look discolored and feel warm to the touch.
At first, the pain will start after you exercise. As the syndrome worsens, you’ll feel it the whole time you exercise and, eventually, also when you’re resting.
How can Physiotherapy help?
Physiotherapy is effective in managing IT band syndrome. The following approaches may be utilised:
- Relative rest – Advice on rest and activity/training modification, allowing the pain and inflammation to settle and the IT band to heal appropriately.
- Patient education – It’s important to understand your condition and to be active in your recovery. You will be given a clear explanation of the diagnosis and any other underlying causes, and we will discuss what is needed in order to settle your symptoms and reach your treatment goals.
- Pain management – Taping the knee to offload and reduce the pressure on the ITB can also help to reduce your pain. Ice can be an excellent modality to help control pain, inflammation and swelling
- Range-of-movement exercise – Your physiotherapist may teach you active, self-stretching methods. They may also do some hands-on, passive stretching with you. Together, these can really help decrease muscle tightness or tension and restore normal motion of your joints.
- Manual therapy – Your physiotherapist may use manual therapy such as massage or soft tissue release techniques to the ITB and surrounding muscles. This will help improve movement and reduce muscle stiffness or soreness. ITB rollers are an excellent way to help release the ITB as part of your home exercise programme.
- Muscle strength – Muscle weaknesses or imbalances throughout the lower limb have been shown in the medical literature to contribute to ITB syndrome. Your physiotherapist will design a safe resistance program to ensure all your lower limb muscle groups are strong and working in synergy. They will also work on your core stability too as it is vital to have a strong centre in order to move your limbs effectively and efficiently.
- Biomechanical and movement re-education – This may involve assessing you doing a specific activity or movement such as running, squatting or jumping, and teaching you how to correct your technique, so that you are activating the correct muscles and moving more efficiently so that you do not aggravate your symptoms. At complete, we also offer specific running and cycling assessment clinics.
- Functional and sports specific training – Once your pain, strength, and range of movement improve, functional training can help you safely resume more demanding activities and get you back to playing the sport that you love.
If you suspect that you have IT band syndrome, please schedule an appointment with one of our Physiotherapists at Bend + Mend and we can help you can back to pain-free exercise sooner.