What is Iliotibial Band Syndrome (ITBS)?
Iliotibial band syndrome is an injury that causes sharp pain in the iliotibial band, especially after sports activities where you bend your knee repeatedly. An iliotibial band is a thick band or tendon that runs from the outside of your hip/pelvic bone down to your knee. It stabilizes your knee during movement.
Runners, hikers, and cyclists in Hong Kong suffer from iliotibial band syndrome. Their sports activities involve frequent bending of the knees; hence, it makes sense why they will be the most prone to this condition.
Symptoms of Iliotibial Band Syndrome
Pain on the outer side of the knee: When you have ITBS, you feel pain in the upper side of your knee joint. Pain comes due to friction caused by flexion and extension of the knee. Pain might disappear when you warm up but gets worse during exercise.
Tenderness or tightness along the IT band: Your area of treatment might feel warm and tender with a touch. You may also notice redness on the outside of the knee.
Swelling and snapping sensation at the knee joint: Swelling happens due to friction between the IT band and the Lateral Femoral Epicondyle. Inflammation is a feeling of fullness on the outer knee, redness, warmth and discomfort while exercising. You might also hear a snapping sound when you flex or extend your knee.
Also Read: Common Running Knee Injuries & Their Treatment
Causes and Risk Factors of ITBS
Common Causes
Overuse: Overuse causes your IT band to be overly tight, causing excess friction when it rubs on your bones. A tight IT band irritates your knee and causes pain.
Tight or inflamed IT band: A tight IT band causes friction when you bend your knees. Bursa is a fluid-filled sac that helps the IT band to move smoothly when you bend. An inflamed Iliotibial band and bursa result in pain of the IT band syndrome.
Weak hip and glute muscles: Weak hips and glutes struggle to absorb impact forces effectively, leading to excessive inward knee collapse while running, which increases stress on the IT band.
Risk Factors
Running on hard surfaces or uneven trails: Running on sloped or uneven terrain forces your body into compensatory movements, causing the IT band to work harder to stabilize the knee and hip. Downhill running, common in Hong Kong’s steep trails, places excessive strain on the IT band, leading to irritation and inflammation.
Poor running form or improper footwear: Overstriding, excessive heel striking, or improper hip alignment can increase stress on the IT band. Wearing worn-out or unsupportive shoes alters biomechanics, potentially leading to excessive instability that strains the IT band. Lack of arch support or incorrect footwear selection can also contribute to improper leg mechanics and ITBS development.
A sudden increase in training intensity or mileage: Rapidly increasing running or cycling distance, frequency, or intensity without proper adaptation can overload the IT band. High-volume hill training without adequate strength conditioning can lead to excessive stress on the outer thigh. Lack of cross-training and recovery increases the risk of muscle imbalances and IT band tightness.
Effective Treatment for ITBS
Physiotherapy & Rehabilitation
IT band stretching techniques build muscles around your IT band, making it stronger. The stretching technique focuses on your quadriceps and glutes. Strong quadriceps and glutes prevent IT band pain, and knee and ankle injuries.
A strong core enhances good balance and stability. Strengthening exercises that focus on the key muscle groups prevent ITBS. The key muscle groups include hip muscles, glutes and thigh muscles.
A foam roller loosens a tight iliotibial band. Before using a foam roller on your iliotibial band, roll your hips, glutes and quadriceps to activate them. According to a 2019research foam rolling is more effective when used as a pre-workout rather than a recovery option. Deep tissue massage releases hip muscles, the neighbouring hamstrings and quads to provide relief.
Rest & Recovery Strategies
Rest the hurt knee so the iliotibial band can heal. You can rest by taking time off, reducing running or cycling intensity. According to theAmerican Academy of Medicine, you should increase the intensity of your activities by 10% weekly. The intensity of activities ranges from pace, duration, distance and weight.
Ice therapy helps to relieve inflammation. Ice therapy can be an ice massage or wrapping an ice pack with a cloth and then placing it around the knee for at least 15 minutes. You can repeat ice therapy every few hours until the pain goes away.
Pain Management Options
Over-the-counter anti-inflammatory options like Ibuprofen and Naproxen help in relieving pain. To enhance the effectiveness of the treatment, avoid activities that trigger ITBS pain.
Knee taping and braces reduce IT band stress and provide support during movement. The tape lifts the skin slightly, reducing pressure on the inflamed tissues. Knee taping improves blood circulation and reduces inflammation.
Preventing Iliotibial Band Syndrome
Proper Running & Cycling Techniques
You can adjust the form to reduce IT band stress. IT band stress comes as a result of overuse, changing your activities can help prevent overload. Warm up before running, and cool down after running.
Gradually increase your training intensity, increasing the intensity and mileage of your exercise can irritate your IT band. For example, if you are just a beginner, run for short distances and increase the mileage as your body adapts.
Also, when running, ensure to engage your core and your glutes to avoid relying so much on your IT band.
Footwear & Equipment Considerations
Proper running shoes provide support. Wear running shoes with good arch support and excellent cushioning for comfort, know the right type of shoe for your feet.
Use orthotics to provide knee and foot alignment. If you have flat feet or excessive pronation, customize orthotics for better support. Well aligned knee and feet prevent irritation of the IT band.
Strength & Flexibility Exercises
Strength and flexibility exercise promotes flexibility, strengthens your muscles and reduces IT band tightness. Some stretching exercises that focus on IT band pain and tightness, include: low lunge variation, standing IT band stretch and glute stretch.
Some strength exercises that strengthen your IT band, glute muscles and hip abductors include: heel drops, side leg abductions and clamshell exercises.
Also Read: 10 Tips to Avoid Exercise Injuries
Where to Get Treatment for ITBS?
At the Hong Kong Sports Clinic, we have physiotherapists who provide treatment and advice on how to treat IT Band Syndrome.
If you are a runner, cyclist, or individual trying to stay active, we provide the best therapy, rehabilitation exercises, and treatments that address the root cause of your IT band problem. Book your consultation today, we are here to help.
Final Thoughts
Addressing IT band issues early can help prevent long-term complications. Treatment options for ITBS include rest, stretching, strengthening exercises, and activity modifications to reduce strain on the IT band.
Seek professional help when pain persists. You can treat ITBS on your own, especially if the pain is mild, however, you require professional help if the pain is too much to bear.
FAQs
How long does ITBS take to heal?
The time it takes for the IT band to heal depends on the severity of the injury. Enough rest, strength, and flexibility exercises restore your balance. If you can do the exercises without pain, gradually resume your sports activities. If the symptoms persist even after self-care, seek medical help.
Can I still run with IT band syndrome?
You can still run with IT band syndrome but listen to your body first. For example, if you experience pain while running but pain stops after you rest, then the IT band pain is not severe. Once you notice the ending pain after running, then it shows that you need to stop and seek medical help.
Is it OK to walk with an IT band injury?
It’s okay to walk with IT band syndrome, however, you should get the permission from your healthcare provider, depending on the severity of the injury. Movement is encouraged for people with ITBS, to reduce knee pain, hip pain and inflammation of the iliotibial band.
Does ITB syndrome go away?
Yes, ITB syndrome can go away with proper treatment. Proper treatment includes rest, physical therapy, ice treatments and over-the-counter treatments. You don’t need surgery to heal from ITBS, however, this can only be recommended by your healthcare provider.
How to sleep with IT band pain?
It band pain can be uncomfortable when you sleep. The best sleeping position is lying on your back and placing a pillow below the affected knee. A pillow elevates your knee to reduce pain.
