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Iliotibial Band SyndromeIliotibial Band Syndrome

Do You Have?

  1. Pain on the outside of your knee or hip region?
  2. Sudden or gradual decreased endurance
  3. Feeling of hip or knee instability

ITB Syndrome Is Usually Caused By

  1. Leg length discrepancies
  2. Contracted tensor fascia lata muscle and IT band
  3. Adhesion between IT band and lateral quad muscle
  4. Improper joint mechanics in the ankle, knee or hip

Iliotibial Band Syndrome (ITBS) typically presents with knee pain on the lateral or outside edge of your knee at the lateral epicondyle of the femur. ITBS typically is worst while running downhill and may even be absent while running uphill. It can even be painful enough to drastically limit or even completely stop training. Iliotibial band syndrome(ITBS) is one of the most common sources for knee pain. It is estimated that 60% of all runners are injured in an average year. About one-third of those injuries occur to the knee, producing a yearly incidence rate of one in five runners.

The Iliotibial Band Syndrome is often labeled an 'overuse' injury. Sometimes a perverse fondness for running can lead to a true overuse syndrome but commonly, runners can be afflicted with ITBS on a regime of just 5 to 10 miles per week, even though such volume would hardly constitute overtraining. The key source of ITBS disorders is actually a lack of strength and flexibility in the iliotibial band fibers themselves.

Most often the pain won't really hit home until after the first one or two miles of a workout have been completed and tends to get worse during downhill running or while walking down steps. The discomfort may radiate up and down the lateral leg, but, strangely enough, the pain will often almost disappear if you stop running and begin to walk slowly and with short steps.

ITB problems don't always occur at the knee. Pain may also be present below the knee, where the ITB actually attaches to the tibia. Discomfort may also occur much higher up in the tensor fascia lata itself or at its tendinous connection at the hip. Contracture of the TFL at the hip pulls on the ITB, shortening the tendon at the knee. This shortening leads to mechanical friction of the tendon leading to localized inflammation and scar tissue formation. As this scar tissue accumulates, soft tissue adhesions can form in the vastus lateralis quad muscle and the biceps femoris hamstring muscle leading to biomechanical compensation syndromes and altered running techniques.

Many predisposing factors can lead to the development of ITBS. Some of the more common sources include over-pronation while running (leading to increased medial rotation of the knee), under-pronation while running (leading to increased varus stress at the knee), poor shoes, running on hard or uneven surfaces, ACL laxity, poor arch support in the feet, etc. The doctors at Active Family Care Chiropractic in Summerville SCwill give recommendations based on history, consult, and exam to determine underlying roots or source of dysfunction and discuss appropriate treatment options.