When training for a distance run, one of the top 5 overuse injuries that runners encounter is called Iliotibial Band (ITB) Syndrome. This syndrome presents itself most often as pain on the outside of your knee during or after a run. The ITB is a thickening of the fascia that runs along the outside of your thigh or femur bone. It connects the lateral hip muscles (gluteus maximus and tensor fascia latae) to the outside of the knee. As the ITB travels down the leg, it narrows, causing the potential for friction between the soft tissue and the bone in the knee. This friction occurs during repetitive knee bending associated with running, squatting, lunging and hills/stairs. The constant rubbing or irritation can cause inflammation leading to knee pain. Several factors in how you train can increase your risk for developing ITB syndrome including a rapid increase in mileage, consistent running in the same direction on a track or outside loop, and running hills and stairs as a workout.
Lateral hip weakness can also lead to ITB syndrome. If the gluteus medius is weak, it places more stress on the tensor fascia latae (both hip abductors) overworking the ITB. Prevention of ITB syndrome should include stretching as well as lateral hip strengthening.
You can use the following strengthening video and stretching video to help prevent ITB.
Initial treatment for this condition includes rest, ice, stretching and massage. The use of a foam roller along the entire length of the ITB can reduce tightness, promote healing, and minimize painful adhesions along the soft tissue. When the pain has subsided at rest and does not return with any daily activities, an incremental return to running progression may be instituted, increasing mileage and speed slowly while monitoring symptoms. A fun, safe way to return to running may be to join a running group such as Team Philly Race Training. This program offers runners (beginner to intermediate) an opportunity to train in a motivated environment with professionals that can assist in coaching, cross training and injury prevention/treatment.
If the pain returns, stop running immediately and return to rest, ice, gentle massage and stretching. If the pain persists for more than one week it may be time to contact a physical therapist, who can help with pain relief and provide the necessary treatment such as Active Release Technique to restore full activity as quickly and safely as possible. If left untreated, this injury may become chronic which will be more difficult to treat and require more time away from running.
- Contributed by: Desirae Gaspero, PT, DPT
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