IIliotibial Band Syndrome – ITBS

It is one of the most common injuries that runners suffer and is often the root cause behind the dreaded  & infamous ‘Runners Knee’. The iliotibial band is a ligament that runs the length of the leg from hip to shin & attaches to the knee, It is generally here that pain is felt as the ITB becomes aggravated, tight & inflamed.  It can be recognised by pain on the outside of the knee which gets worse during running, particularly if going downhill, the good news is that you’re unlikely to do long term damage by continuing to run – but it is just as unlikely to ease and the severity of pain and speed of onset will increase.

Here are my top ten tips for preventing iliotibial band syndrome:

  1. Most importantly, always decrease your mileage or take a few days off if you feel pain on the outside of your knee.
  2. Strength & Conditioning
  3. Walk before you start your runs.
  4. Make sure your shoes aren’t worn along the outside of the sole. If they are, replace them.
  5. Avoid running on a cambered surface continuously
  6. Try running on softer or mixed surfaces like grass & sand.
  7. If you change on a track change directions.
  8. See a podiatrist to check if you need orthotics.
  9. Lower drop shoes may help with a more natural running form
  10. Concentrate on form

So it’s too late & you didn’t find my tips for preventing ITBS, what to do know? Simple – read my top ten tips for treating Iliotibial Band Syndrome (ITBS)

  1. Rest – the first & most important step if you’re suffering from ITBS. If you continue to run it will aggravate the injury & you may end up with a chronic case.
  2. Ice – a tried & tested technique to reduce the inflammation & ease pain. A recommended course is apply ice for 10 mins every hour until pain has eased.
  3. Anti- Inflammatory Medication – Ibuprofen or Aspirin will help in reducing the inflammation as will prescription drugs such as Naproxen.ITBS Stretch ITBS Stretch
  4. Stretching – regular stretching will help as part of a conservative treatment programme. A couple of good ones to ease ITBS are to lie on your back, bring the injured knee up to your shoulder then push it over the opposite shoulder with hand or elbow. Another effective stretch is to stand upright & cross the injured leg behind the good leg. Then reach past the good knee towards the foot of the injured leg, you don’t have to reach the foot for this to work.
  5. Foam roller – This WILL hurt when done properly, but it is a great way to release the iliotibial band. I always think it feels like an elastic band snapping in your leg when your rolling it! As always with foam rolling take care to ensure you don’t cause other damage.
  6. Strength & Conditioning – Avoid exercises that will aggravate the ITBS and focus on glutes & hip flexor’s as weakness or imbalance in these area’s is most commonly the cause of the inflammation. A great source of exercises is the Sports Injury Clinic.
  7. Surgery – A final course of action if nothing else has worked!
  8. Physiotherapy – massaging will help release tightness of muscles that may be causing the imbalance that is causing the inflammation, a good physio will identify the cause & give you exercises to improve strength & flexibility avoiding further problems
  9. Ultrasound &/or Electrical Stimulation – a disputed form of treatment that is used by PT’s but has not got the supporting research to prove that it is truly effective – like ice baths or compression clothing. Home ultrasound kits are available but care should be taken as you can burn yourself which probably won’t help ITBS recovery.
  10. Cortisone – Not recommended unless none of the other treatments have helped as although this powerful anti inflammatory has been proven to significantly reduce pain it may also cause other side effects such as thinning of the cartilage or weakening of the ligaments.

One final point I have to add, although I would never propose it as a sensible option to treat ITBS, after my last time suffering with this problem I ran London Marathon, struggling from around 11-12miles with the ever increasing pain as my iliotibial band became more & more inflamed. Once I had hobbled over theline I got a massage & they focused most of their attention on the offending ligament.

6 days later I ran a 60 ultra. Pain free. Well, pain from the ITBS free anyway.