The ITB(iliotibial band) is a fibrous, non elastic tissue running from the outside aspect of the hip to just below the outer part of the knee. It functions to help stabilize the hip and knee and aids in posture control.
ITB irritation is one of the most common causes of knee pain experienced by runners. It can also be the cause of pain with activities which require you to repetitively bend and straighten your knee, such as cycling, hiking and walking long distances. Irritation of the ITB comes from friction of the ITB and the underlying structures.
The main complaints include:
- A nagging pain on the outside of the knee
- Popping or snapping may be felt
- Pain continuing after the aggravating activity, worst with walking or going down stairs
There are multifactorial causes for ITB irritation. These can be divided into three categories.
Physical Conditions
- hip abductor weakness leading to decreased stability in the knee with prolonged activities
- tightness in the outer thigh muscles(specifically the outer quadriceps muscles)
- excessive foot pronation
- bowed legs
Training Techniques
- Not warming up or cooling down enough after your activity
- Pushing too hard or going too long without adequate time to build up to the new level of activity
- Wearing worn out shoes
Training surface
- Running downhill
- Running on a banked surface, such as mainly running on one side of the road. Roads slope towards the curb, making your outside foot lower, causing increased stress to the knee
Treatment
Treatment is focussed on the underlying cause of the irritated ITB and may vary from individual to individual.
Treatment may include:
- strengthening of the weak hip abductor muscles of the affected knee
- manual therapy involving hands on work to help lengthen and stretch out the tight outer quadriceps muscle
- functional training exercises focussing on teaching you how to perform controlled and coordinated movements specific to your sport or activity of daily living and help you learn the correct way to move without aggravating your knees
- with excessive pronation, the issue can be addressed with foot muscle strengthening exercises, adjustments in footwear, or possibly orthotics
If you are experiencing knee pain call the experts at the Durham Orthopedic and Sports Injury Clinic for an assessment to determine the cause of your knee pain at 905-428-7800.
