What is the Iliotibial Band?
The Ilio-Tibial Band (ITB) is a long thick band of fascia that runs from the from the hip down to the outside of the patella. The ITB attaches to the gluteus maxiumus and the tensor fascia latae. The role of the ITB is force transmission through the legs into the pelvis during weight bearing.
What is ITB Syndrome?
ITB syndrome (sometimes called ITB Friction Syndrome) refers to the pain and inflammation that occurs at the insertion point on the outside of the knee, normally associated with excessive compression from the ITB. This is a common complaint, especially among runners, cyclists and soccer players. It often also gives trouble in hikers who walk a lot of hills.
What causes ITB Syndrome?
The cause is often multi-factorial:
- running too much or excessive downhill walking/running
- excessive tightness in the hip flexors, hamstrings, quads
- weak core and hip stabilisers
- old or inappropriate shoes
- over-pronation (“flat”) feet
- poor bike set-up
- nutritional deficits
What can I do to help?
- take a break from aggravating activities
- ice the affected area to reduce inflammation
- foam roll* the quads and ITB each day (after exercise is the best time)
- swim to maintain fitness levels
- yoga / pilates cross training to improve movement quality
*Be careful not to roll the ITB too aggressively (think less than 5/10 pain) as it can trigger off the fight/flight system that can further tighten things up.
One of the biggest causes of ITB issues is a weak butt muscle. When running, the glutes should take most of the load. The gluteus maximus is the biggest and most powerful muscle in the body. But in the presence of pain, injury or excessive sitting it ‘switches off’ and other muscles (hip flexors, ITB, quads, calf and hamstrings) are forced to compensate.
Switching on the gluteus maxiumus and medius is the key to taking pressure off of the ITB.
Here are some of our favourite exercises to get your glutes back online and functioning:
- clam
- bridge
- single leg bridge
- reverse lunge
- squats
- single leg squats
What can a Physio do to help?
- Assessment and provide accurate diagnosis
Running Assessment to observe technique plus looking at all possible underlying biomechanical issues. - Relieve symptoms & encourage healing process
Massage, dry needling (in particular hip flexors, TFL, quads, hamstrings, glutes) to improve healing quality and re-set high muscle tone. - Set up a personalised home exercise program
Developing a home movement practice to support your body will be a critical part of your recovery. Initially we’ll focus on a few key exercises and they’ll be delivered through the MyPhysio App program on your phone. Also we’ll give you specific advice about how to resume your sport safely.
How long will it take to get better?
A mild case may take 3-4 weeks to get better. Chronic issues may take 3-6 months to fully rehabilitate.
How can I prevent this happening again?
The key to preventing ITB issues is to strengthen the core and glutes, maintain the flexibility in the ITB and quads and then gradually return to activity. If you are a runner, experiment with running with a cadence of around 170-180 per minute. This has shown to decrease peak loads through the leg and improve running efficiency.
It’s important to address all of the underlying factors to order to overcome ITB injuries in the long run. If you feel some niggles early on that resemble ITB syndrome, getting onto it ASAP will help keep you active and pain-free.
Want to learn more?
Head to our Contact Us page to book in for:
- Running Assessment
- Foam Roller W/Shop
- Hands on release and Dry Needling
