ITB syndrome is a common problem for runners and starts as pain on the lateral or outer side of the knee. It is caused by friction or rubbing of the ilio-tibial band (ITB) against the outer tissues and structures of the knee, and you guessed it, it causes a lot of pain when running.
The ITB itself stands for Ilio-Tibial Band and it is just that – a band of tight tissue that spans between the hip and the knee. It is not particularly elastic or flexible like a muscle as it is designed to be tight to stabilise the hip and knee function. So when you are told you have a tight ITB that is exactly how it should be. The problems come when it is too tight and is causing pressure on the exposed structures underneath. So whilst some stretching is helpful for your ITB, it is often not enough to fix this problem. Your ITB has become too tight for a reason, and it is in finding that reason that the key to removing your pain lies.
Get yourself a good diagnosis, and that’s not just being told you have ITB syndrome, but actually the reason why you have ITB syndrome. ITB syndrome often stems from a mechanical imbalance in the whole lower extremity. Foot, knee, hip and pelvis mechanics can all play a part, as well as the likely muscle imbalances that can precede and/or cause this injury. If your health professional just rubs your leg and tells you to roll on a golf ball or foam roller, ask for more. You need a full diagnosis of why you are getting the knee pain, and a good plan to solve it.
Over twelve years of clinical practice has shown us that one common cause of persistent ITB syndrome is a pelvic imbalance. A twist in the pelvis can make the stride length slightly reduced on one side, resulting in a muscle length imbalance in the upper leg and pelvis and overload of the joints in the opposite leg. Some of these muscles then end up working too hard, tighten up, generate pain and then undergo premature fatigue causing further biomechanical stress in all of the leg structures. When the ITB becomes tight it creates pressure and friction on the uppermost edge of your shin bone where it attaches into, and everything that passes beneath this part of the ITB gets a bit squashed. With everyday levels of walking this is often not too troublesome, but as your knee bends a lot more and has the impact strike with running, the structures at edge of the knee can become sore and inflamed underneath the pressure of the tightened ITB.
Please don’t let a non-resolving ITB Syndrome stop you running. This is a very treatable problem, and if whoever you are seeing is not fixing it quickly, consider shopping around for another form of treatment. Ask for more from your therapist – ask why this injury is happening, ask how long it will take to recover, and ask what else they could be looking at to speed things up and prevent it from coming back.