Iliotibial band syndrome is a common overuse injury that causes pain at the outer knee. The iliotibial band (ITB) is a thick band of connective tissue and tendon that runs down the outside of your thigh, from the hip down to the knee. It functions as a stabiliser for the hip and helps us balance.
Fun fact: humans are the only animals with ITBs! We are born without them and gradually develop them as we start standing, walking, and jumping.
Most know ITB syndrome as a runner’s injury, but it can be caused by any endurance sport or activity with repetitive load through the ITB such as cycling, hiking, rowing, and hockey. ITB syndrome is usually triggered by an increase in length or intensity of training (e.g. running longer distances or on more uneven terrain), or by improper training technique. ITB syndrome affects more men than women, although it is still the most common lower limb injury among women in sports.
Symptoms of ITB syndrome include:
- Sharp pain on the lateral knee, especially on heel strike while walking
- Pain can get worse walking/running downhill/downstairs/long distances
- Swelling over lateral knee
- Audible clicks or a snapping sensation with knee motion
- Tenderness or burning pain over lateral knee when pressure is applied
- Weakness of hip abductors
Treatment can involve:
- Rest: stopping or significantly decreasing the activities that aggravate the condition (this doesn’t mean you have to stop exercise altogether! A form of exercise that doesn’t put heavy load through the knee, such as swimming, can substitute during rehab)
- Ice or heat to reduce inflammation and pain
- Taping to support the knee while the pain is still in the acute stage
- Exercises to strengthen hip abductors and improve hip stabilisation
- Soft tissue and myofascial trigger point manual therapy techniques to increase blood flow and release points of tissue tension
- Shockwave therapy to promote healing and reduce pain