Relief for Iliotibial Band Syndrome
By: Dr. Peggy Malone
What is Iliotibial Band Syndrome?
Also known as Runner’s Knee, Iliotibial Band Syndrome is a painful affliction most often suffered by runners.
In fact it is one of the most common repetitive strain injuries in runners. I have experienced it myself and I see it in my office almost every day.
The first symptoms that people usually feel are pain and swelling and sometimes clicking on the lateral (outer) side of their knee. These symptoms fool people into thinking that they have a knee injury, when really the culprit is further up the anatomy train.
Iliotibial Band Syndrome is often treated with NSAIDS (over the counter medications), ice, stretching, massage and sometimes cortisone injections.
This approach may give temporary relief but the true cause of this often debilitating injury lies in the biomechanics, strength and function of the hips and pelvis so until these factors are addressed, it is difficult to get true healing.
The Iliotibial band is a fibrous band that runs from the hip to the shin or from Tensor Fascia Latae muscle attached to the Ilium (part of the pelvis) all the way down the side of the thigh to the lateral side of the tibia (shin bone).
The Iliotibial band’s job is to help the gluteus medius and gluteus minimus muscles to abduct and stabilize the hip and pelvis.
Wait a minute, this sounds familiar…we have discussed the dysfunction of the gluteal muscles in relation to Shin Splints and other running injuries too!
Weakness and dysfunction in the hips and glutes is extremely common in runners and contributes to every repetitive running injury from the floor to the core including:
Achilles Tendinitis or Dysfunction
Iliotibial Band Syndrome
Chronic Hamstring Strain
That is quite the list and the common denominator that I always come back to when working with athletes in my practice….the glutes.
Let’s talk about Iliotibial band syndrome specifically for a minute.
As we have learned in previous posts, the massive amount of sitting that we all do in our day to day lives puts us at a huge disadvantage when we then stand up and go to run.
The sustained sitting posture creates a biomechanical and neurological situation where the hip flexor muscles are extremely shortened and tight and the gluteal musculature goes ‘On Holidays’ and signs over its work to other muscles such as the quadriceps, hamstrings and low back extensors.
When you lose the function of your gluteus medius and minimus muscles, you lose your major pelvic stabilizers every running step you take.
As a result, you get wobbly hips which means your poor TFL (tensor fascia latae) and ITB (Iliotibial band) are stressed with more force than they are designed for with each running step.
This creates the repetitive strain injury that we are all here for today known as Iliotibial Band Syndrome.
So, the true relief for this problem lies in strengthening and (more importantly) increasing function in the hips and glutes.
I have outlined 5 great exercises to help you do this in a previous post.
Ok, so it takes awhile to get stronger…
What can you do for relief in the meantime?
Use Ice: Every Hour for 10 minutes.
Rest: It’s ok to take some time away from running as you get healthy.
Crosstrain: Other activities such as cycling and swimming may be less aggravating and will keep your cardiovascular fitness rocking.
Run on a flat surface: When you do go back to running, avoid the country side road runs with the angled shoulders that bring patients to my office in droves every year with ITB symptoms.
Stretch: And don’t just stretch your ITB. Stretch your hip flexors because by opening the front of the pelvis, you will increase the likelihood that your glutes will wake up from their slumber and actually do their job.
Also, use a foam roller to stretch out and open up the quadriceps and the Iliotibial band.
Check out the video where I demonstrate how to do this:
When you are running, there are a couple of things that you can do to give you relief in the moment if the symptom at the knee starts to ‘say hello’.
If it is your right knee, focus on activating your gluteal musculature on the right side every time your right foot hits the ground. (you can increase the likelihood of contraction in the correct muscle by placing your hand on your gluteus medius muscle)
This really works!
Also, if you are on a hill (going up or down) and the pain is bad…shuffle sideways.
This really works too!
Both of these techniques should be used for race day pain only. If you are in pain during training, it’s better to stop and focus on recovery before you head back out again.
It really is possible to get past the awful pain of Iliotibial Band Syndrome and get back to the running that I know you love
Live Well and Happy Running,
Dr. Peggy Malone is a Chiropractor and an Athlete who helps other athletes to overcome injury and get back to their sport. Her weekly Television Series 'Living Well" inspires people from all walks of life to take control of their health to be as happy and as healthy as they can be.
A former varsity Basketball and Rugby player, she has since entered the world of endurance athletics where she has completed 2 Ironman Triathlons, 3 Marathons, several Half Marathons and many other Triathlons, Road Races and Off-Road Adventure races of varying distances.
Her own athletic endeavors and injuries have given her valuable insight into working with athletes in her practice for both the care of injuries as well as for the improvement of athletic performance.
Great Article! Thank you for sharing your expertise.
You are welcome Kevin. I’m glad you found something useful!
Great Article! Thank you for sharing your expertise.