Iliotibial Band Syndrome – Problem and Resolution

Iliotibial Band Syndrome is an overuse injury of connective tissue resulting in pain on the external part of the knee. It is caused by excessive friction of the distal iliotibial band, as it slides over the lateral femoral condyle during repetitive flexion and extension of the knee, thereby resulting in friction and potential irritation.

Pain Presentation:

The primary initial complaint in patients with Iliotibial Band Syndrome is diffused pain over the lateral aspect of the knee. These patients are frequently unable to indicate one specific area of tenderness but tend to use the palm of the hand to indicate pain over the entire lateral aspect of the knee. With time and continued activity, the initial lateral achiness progresses to a more painful, sharp and localized discomfort.

Typically, the pain begins after the completion of a run or several minutes into a run; most commonly felt when the foot strikes the ground and might persist after activity

It will also hurt if you twist your knee to turn a corner.

However, as the Iliotibial band becomes increasingly irritated, the symptoms typically begin earlier in an exercise session and can even occur when the person is at rest.

Patients often note that the pain is aggravated while running down hills, lengthening their stride, or sitting for long periods of time with the knee in the flexed position

Causes of Iliotibial Band Syndrome:

• Consistent running on a horizontally banked surface (such as the shoulder of a road or an indoor track) on which the downhill leg is slightly bent inward, causing extreme stretching of the band against the femur
• Inadequate warm-up or cool-down
• Excessive up-hill and down-hill running
• Positioning the feet, with toes tucked inwards, to an excessive angle when cycling
• Running up and downstairs

Treating Iliotibial Band Syndrome:

The treatment requires activity modification, massage, and stretching and strengthening of the affected limb. The goal is to minimize the friction of the iliotibial band as it slides over the femoral condyle. The patient may be referred to a physical therapist, who is trained in treating Iliotibial Band Syndrome.

At AktivHealth, our focus is to alleviate pain and inflammation by using manual therapies like myofascial releases, taping, dry needling, and various mobilizations and manipulations (chiropractic techniques). We also include patient education and activity modification for successful treatment.

Once the acute stage diminishes, our focus switches to fix the biomechanical alterations by stretching and strengthening the associated muscle slings to avoid reoccurrence.