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ITB Syndrome injuries and prevention for runners

October 9, 2012 by eriksusie

The Illiotibial Band (ITB) originates above the hip and attaches on the outside of the knee. Most runners with ITB syndrome will feel symptoms of knee pain on the outside of the knee. Pains can be dull or sharp. The ITB can be aggravated by going up and down stairs, lateral motions, crossing legs and continuing to run under irregular conditions. This injury is different than the classically described “Runner’s Knee”. The ITB is a non-contractile fibrous tissue. The ITB functions to create lateral stability to the lower extremity. The ITB does not have a great blood supply. This limit of blood flow may result in sensitivity to the ITB and also slow injury recovery if not treated properly.

The Injury
Weak and poorly coordinated hip muscles can lead runners to ITB symptoms. Weak hip muscles usually result in misalignment of the hip, knee and foot/ankle.

Lack of strength in a specific hip muscle, the gluteus medius, can lead to collapse of the knee inward under load, such as single foot stance. A collapse of the knee creates irregular fractioning of the ITB over the outside of the knee, thus creating an inflammatory condition.

Excessive pronation at the foot and ankle can also lead to ITB syndrome. This excessive motion at the foot and ankle can create irregular rotations at the knee and hip, thus resulting in ITB fractioning at the knee.

Injury Management
Effective management of ITB syndrome is to recognize symptoms early and discovery why you are having the problem. Utilize your chosen healthcare provider to help discover the origins of your injury. This evaluation should include a review of your current running shoes, musculoskeletal evaluation (flexibility, strength, skeletal symmetry/asymmetry, coordination), and training records. Acute symptoms are best treated with ice and relative rest (activity without pain).

Prevention of ITB Syndrome is accomplished with running shoes that meet the needs of the individual. Specialty running shoes stores often offer basic running analysis to help get you in a shoes that meets your needs. A Physical Therapist trained in running issues can provide a comprehensive and effective running-gait analysis. Findings from this analysis will best guide your shoe selection. A well qualified Physical Therapist should be well aware of the shoe market and be able to best guide you towards two or three appropriate shoe choices for your running style.

Strengthening your hips is your best preventative tool for ITB symptoms. Side to side motions, or lateral motions are the best way strengthen your hips.
Examples of these exercises include; crab walk, side lunges, and standing or side-lying leg raises.

Mobilization or stretching of the ITB can help lessen tension-related friction of the band at the lateral knee. It is difficult to stretch the ITB due to the anatomy of this fibrous band. The easiest way to improve the mobility of the ITB is the incorporation of manual/pressure techniques. These include the use of a massage stick (Tiger Tail, The Stick), foam roll, or manual (use of hands) techniques. All mobilization techniques should be performed with moderation.

A key preventative tool is having variety in your training. Cross-training with elliptical, swimming or bicycling are smart choices. Also, try varying distance, pace and surfaces when you run. And always remember to listen to your body!

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