ITB Friction Syndrome

Don’t let ITB Friction Syndrome ruin your workout

Iliotibial Band Friction Syndrome (ITB Friction Syndrome) is one of those debilitating injuries that can stop a runner their tracks and is not just limited to runners. Cyclists, hikers and military personnel are also at risk.

So what is your ITB and how do things go wrong?

Your ITB is a long, flat, fibrous band running from the top of your pelvis down the outside of your leg to insert down on your tibia and femoral condyle (the bony end of your thigh bone). As your knee bends and straightens, during running, cycling etc, the bottom end of the ITB slides across the outer condyle of your femur and can cause excessive friction and therefore inflammation and pain. The most likely point where friction can occur is when your knee is bent to 30 degrees (think downhill running).

Common risk factors for developing ITB Friction Syndrome are:

  • Poor lower limb biomechanics and balance
  • Weak gluteal muscles
  • Underactive inner quadriceps
  • Insufficient trunk core muscles
  • Poor foot biomechanics
  • Worn out or unsuitable runners
  • Sudden increase in mileage for training
  • Excessive hill training  in particular downhill
  • Training for endurance events (half marathon and beyond)
  • Training/competing on unstable ground (eg bush tracks)
  • Stiff ankle joints (perhaps related to a past injury)

What are the symptoms?

People commonly describe a sharp pain or burning sensation on the outer side of their knee and or thigh. Onset is usually gradual over a period of a few weeks and the pain worsens with running, walking or running downhill, stairs and knee bending.

Diagnosis of ITB Friction Syndrome?

Diagnosis is relatively straight-forward in the clinic, therefore does not usually require radiological investigation. Your physiotherapist would look at your balance, muscle strength, lower limb control, joint range and core stability as well as discussing footwear and training programs. Where possible it is beneficial to perform a running or cycling video analysis to visualise your lower limb biomechanics in action.

Treatment of ITB Friction Syndrome

Treatment can be very effective once all contributing factors have been identified. Physiotherapy management commonly consists of manual therapy such as ankle joint mobilisation and soft tissue techniques.  We would also include specific hip and pelvic strength work, agility and balance exercises.   It is important for us to address your training regimes and design sport specific drills for you.  The ultimate goal is to get you to the finish line successfully. Occasionally we may suggest a corticosteroid injection (performed by a sports’ physician) but in most cases,  conservative management will get you there.

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