What is ITBS?

Iliotibial Band Syndrome (ITBS) is a common injury among runners and is characterized by pain or aching at the lateral side of the knee, which generally occurs partway into a run. As the condition worsens, the pain gets more intense and onset occurs closer to the beginning of the workout.

The IT band begins in the hip as the tensor fascia latae muscle and has attachments at the origin from three different muscles: the gluteus medius, gluteus minimus, and vastus lateralis. The muscle becomes a fibrous band of tissue as it progresses down the thigh, then crosses the knee joint, and inserts along the lateral (outside) portion of the patella (knee cap) and into the tibia (shin) bone on a bump known as Gerdy’s Tubercle.

Symptoms of ITBS

Iliotibial Band Syndrome symptoms range from a stinging sensation just above the knee joint (on the outside of the knee or along the entire length of the iliotibial band) to swelling or thickening of the tissue at the point where the band moves over the femur. The pain may not occur immediately during activity, but may intensify over time, especially as the foot strikes the ground. Pain might persist after activity. Pain may also be present below the knee, where the ITB actually attaches to the tibia.

Common Cause of ITBS

Hip abductor muscle weakness, most commonly in the gluteus medius, is one of the main causes of ITBS. Although the pain is felt at the knee, the root of the problem is actually located closer to the hip. The tensor fascia lata inserts into the ITB and is responsible for hip abduction. When other hip abductors such as the gluteus medius are weak, the tensor fascia latae must compensate. The end result is an overworked tensor fascia lata and a stressed and tight ITB. The tight ITB will rub on the femur (actually on the femoral area on lateral side of knee) and cause friction. The friction leads to inflammation in the area and pain.

Prevention / Treatment of ITBS

The following guidelines are for information purposes only. Seeking professional advice before beginning rehabilitation is recommended.

The recommended activities to prevent ITBS are:

• Stretch quadriceps, hamstrings and gluteals regularly.
• Do some strength work to prevent any muscle imbalances, especially with hip abductors.
• Increase running mileage gradually.
• Be sure to take adequate rests between workouts.
• Make sure you are using proper footwear. For example, over-pronators need motion-control shoes and / or orthotics.

Massage Therapy

Regular deep tissue sports massage performed by our skilled therapists at Advanced Alternatives Massage Therapy can help prevent muscle strains by increasing flexibility within the Quadriceps, Hamstrings, and Abductor muscles. Specialized techniques to further lengthen the IT Band are helpful in relieving symptoms. The application of Myofascial Release has proven effective in restoring flexibility to hypertonic tissue.