From Pain to Performance: Conquering IT Band Syndrome for Runners

ITB syndrome, short for Iliotibial Band Syndrome, is the second most common running injury and most common reason for lateral knee pain in runners usually characterized by pain on the outer side of the knee (1). This condition can be debilitating if not properly managed, so let's look into the causes, preventive measures, and rehabilitation strategies for ITB syndrome.

WHAT IS IT BAND SYNDROME

The Iliotibial band (ITB) is a thick band of fascia, or a connective tissue that runs along the outside of the thigh, from the hip to the knee. Its roles include pelvic stabilization and posture control as well as stabilization of the knee during movements like running or walking (2). ITB syndrome occurs when this band becomes tight or inflamed, leading to friction as it rubs against the outer part of the knee joint (3). This repetitive friction can cause irritation and pain, particularly during activities that involve bending and straightening the knee, such as running (1, 4, 5, 6).

CAUSES IT BAND SYNDROME

Several factors contribute to the development of IT Band syndrome:

• Overuse: Engaging in repetitive activities that stress the ITB, such as running long distances or on uneven surfaces, can lead to irritation (3, 6).

• Biomechanical Issues: Poor running or cycling mechanics, including excessive pronation of the foot or leg length discrepancies, can alter ITB function and contribute to syndrome development (5, 7).

• Muscle Imbalances: Weakness or tightness in muscles surrounding the IT Band, such as the gluteal muscles or quadriceps, can affect ITB stability and lead to syndrome (1).

• Poor Training Practices: Sudden increases in training intensity or volume without adequate rest can strain the IT Band and predispose individuals to injury (6).
  
  

PREVENTION OF IT BAND SYNDROME

Preventing IT Band syndrome involves addressing the underlying causes and adopting healthy training practices:

• Gradual Progression: Increase training intensity and volume gradually to allow the body to adapt.

• Proper Gear: Ensure proper footwear and equipment suitable for your activity.

• Strength and Flexibility: Incorporate strength training exercises that target the hip abductors, glutes, and quadriceps, as well as stretching exercises to maintain flexibility in the ITB and surrounding muscles.

• Biomechanical Assessment: Consider a professional assessment of your running technique to identify and correct any issues contributing to ITB syndrome (4, 5). At Pursuit physiotherapy, Vald force decks are used to assess an individual's strength, power, and balance by measuring the forces exerted during various movements, such as jumping, landing, or squatting.

• Chiropractic Care: Regular chiropractic care can help maintain proper joint function and address any musculoskeletal imbalances. Chiropractors can provide adjustments that help improve joint mobility and soft tissue work to reduce tension to the ITB, contributing to better biomechanics and reduced risk of injury.

IT Band Syndrome

REHABILITATION OF IT BAND SYNDROME

If you're already experiencing symptoms of IT Band syndrome, the following rehabilitation strategies can help:

• Rest and Ice: Initially, rest from aggravating activities and apply ice to reduce pain (3).

• Stretching and Foam Rolling: Studies have shown that performing gentle stretches for the quadriceps, and hip flexors, pre-workout is able to acutely improve flexibility. Foam rolling the TFL can also help release tightness in the ITB (8).

• Strength Training: Gradually introduce strengthening exercises for the gluteal muscles, hip abductors, and quadriceps to improve stability and reduce strain on the ITB (4, 9).

• Biomechanical Corrections: Address any underlying biomechanical issues through corrective exercises or adjustments in running technique (4, 5).

• Chiropractic Care: Chiropractic adjustments and soft tissue therapies can aid in relieving pain and improving mobility. Chiropractors can also provide guidance on posture, gait, and exercise modifications to support recovery and prevent future episodes of ITB syndrome.

CONCLUSION

IT Band syndrome can be a frustrating injury for athletes, but with the right approach, it can be managed effectively. Understanding its causes, preventive measures, and rehabilitation strategies is crucial for both preventing its onset and facilitating recovery. By adopting balanced training practices, maintaining flexibility and strength, and addressing any biomechanical issues early on, athletes can minimize the risk of IT Band syndrome and stay on track with their fitness goals.

Remember, if symptoms persist despite conservative measures, consulting with a Victoria chiropractor or physical therapist is advisable to tailor a rehabilitation plan specific to your needs. With patience and persistence, ITB syndrome can be overcome, allowing athletes to return stronger and more resilient than before.

References

1. Baker, R. L., & Fredericson, M. (2016). Iliotibial band syndrome in runners: biomechanical implications and exercise interventions. Physical Medicine and Rehabilitation Clinics, 27(1), 53-77.

2. Balachandar, V., Hampton, M., Riaz, O., & Woods, S. (2019). Iliotibial Band Friction Syndrome: A Systematic Review and Meta-analysis to evaluate lower-limb biomechanics and conservative treatment. Muscles, Ligaments & Tendons Journal (MLTJ), 9(2).

3. Jiménez Díaz, F., Gitto, S., Sconfienza, L. M., & Draghi, F. (2020). Ultrasound of iliotibial band syndrome. Journal of ultrasound, 23, 379-385.

4. Foch, E., Reinbolt, J. A., Zhang, S., Fitzhugh, E. C., & Milner, C. E. (2015). Associations between iliotibial band injury status and running biomechanics in women. Gait & posture, 41(2), 706-710.

5. Aderem, J., & Louw, Q. A. (2015). Biomechanical risk factors associated with iliotibial band syndrome in runners: a systematic review. BMC musculoskeletal disorders, 16, 1-16.

6. Merlo, M., & Migliorini, S. (2019). Iliotibial Band Syndrome (ITBS). Triathlon Medicine. https://doi.org/10.1007/978-3-319-33234-5_7.

7. Earl, J. E., Monteiro, S. K., & Snyder, K. R. (2007). Differences in lower extremity kinematics between a bilateral drop-vertical jump and a single-leg step-down. Journal of Orthopaedic & Sports Physical Therapy, 37 (5), 245-252.

8. Connolly, G., Hammer, R. L., Powell, J. A., & O’CONNOR, P. L. (2020). A single bout of foam rolling increases flexibility of the hip adductor muscles without compromising strength. International Journal of Exercise Science, 13(7), 938.

9. Snyder, K. R., Earl, J. E., O’Connor, K. M., & Ebersole, K. T. (2009). Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. Clinical biomechanics, 24 (1), 26-34.