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A Runner’s Nightmare: Iliotibial Band Syndrome

Iliotibial band syndrome or ITB syndrome. Many a runner has been sidelined for long stretches of time by this condition, so let’s give you the information you need to resolve this.

The iliotibial band is a connective tissue sheet that runs along the outside (lateral) thigh. It connects to the crest of your pelvis (where you would put your hands if I said put your hands on your hips) to your shin bone (tibia) just below your knee. The Iliotibial band’s anatomy is complex but its main job is to stabilise the knee. Most people are blissfully unaware of the iliotibial band’s existence until it starts giving you pain: iliotibial band syndrome.

The syndrome typically gives pain on the lateral aspect of the knee, especially if running downhill or walking downstairs. Other than a sprain, little else will give you pain on the outside of your knee, so it makes diagnosis pretty easy. At the upper outer thigh, the ITB passes over the greater trochanter, which is a bony prominence of the femur close to the hip joint. If the ITB is tight it may rub against the greater trochanter and give upper “hip” pain. The ITB can also cause a “hip snapping” which is an audible snapping that the ITB makes as it moves over the greater trochanter when walking.

Some of the possible contributing factors for ITB problems are:

  • Pelvic misalignment: If the pelvis has misaligned the ITB may be pulled tighter on one side. This MUST be especially considered if the ITB syndrome is on one side only. Overuse generally produces ITB syndrome on BOTH sides.
    over pronation, which is when people have a low arch to their foot.
  • Building running distance too quickly.
  • Too much hill work.
  • Tight glutes. The Gluteus Maximus attaches into the ITB. If the Gluteal muscles are tight then this can also be a complicating factor.

Effective management of this condition includes:

Primarily…address the faulty pelvic mechanics. This is where your chiropractor comes into play. If possible, try to find one who has a good working knowledge of sports injuries. Again, consideration of a pelvic misalignment is essential if you have ITB syndrome on one side only.

Proper footwear, there are many running shops out there that can help you with this.

  • Rest or ease back from running whilst having treatment for your condition. Contemplate a slow build up to hill/stair workouts.
  • Ice the ITB to reduce inflammation. 20 minutes is a good guideline. Be sure to place a tea towel between the ice pack and the skin. Avoid anti-inflammatories as they can actually lead to injury.
  • Stretch the Iliotibial Band. Ask your chiropractor to give you a couple of good stretches for this. *NOTE* this is an extremely thick piece of connective tissue and is not a muscle. It requires dedicated work and gives slow progress. It is vital to complete stretches at home as soft tissue work done by your chiropractor or massage therapist in the clinic simply isn’t enough.
  • Stretch the Gluteal complex. They might not always be the cause but it doesn’t hurt to stretch them out.
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