The Iliotibial band is a thick tendon that inserts on the outside of your knee. The function of the Iliotibial band is to help slow movement and torque at your knee during impact. A common cause of knee pain for many runners is Iliotibial band syndrome. The cause is repetitive trauma to the Iliotibial band insertion on the outside of the knee resulting in tendonitis and severe lateral knee pain while running. Eventually this condition will result in degeneration of the tendon and progress to a condition called tendinosis. This may become a cause of chronic knee pain for the runner as there will be excessive tightness due to abnormal scar formation.
A physiotherapist can diagnose Iliotibial band syndrome through a thorough subjective and objective examination however scans such as ultrasound or MRI may be used to assist with diagnosis. Most cases of Iliotibial band syndrome settle well with appropriate physiotherapy. By carefully assessing the client and determining the factors that have contributed to the development of the condition, the Physiotherapist can set a plan in place to correct these factors. The success rate of treatment is largely dictated by patient compliance.
The key components of treatment:
The patient rests sufficiently from ANY activity that increases their pain until they are symptom free. Activities which place large amounts of stress through the ITB should be minimised, these include: running, squatting, jumping, and going up and down stairs. To allow the body to begin the healing process in the absence of further tissue damage, exercising into pain must also be avoided. Once the patient can perform these activities pain free, a gradual return to these activities is indicated provided there is no increase in symptoms. Ignoring symptoms or adopting a ‘no pain, no gain’ attitude is likely to lead to the problem becoming chronic.
To ensure a speedy recovery time immediate, appropriate treatment in patients with this condition is essential. Once the condition is chronic, healing slows significantly resulting in markedly increased recovery times. The R.I.C.E regime is beneficial in the initial phase of the injury (first 72 hours) or when inflammatory signs are present (i.e. morning pain or pain with rest). The use of a compression bandage and keeping the leg elevated will help reduce inflammation and pain. By reducing the pain and swelling associated with inflammation, Anti-inflammatory medication may also significantly hasten the healing process.
Exercises:
Patients should perform pain-free flexibility and strengthening exercises as part of their rehabilitation to ensure an optimal outcome. One of the key components of rehabilitation is pain-free stretching of the ITB along with pain-free strengthening of the vastus medialis obliquus muscle (VMO). This is often in combination with core stability, pelvic and gluteal strengthening exercises to improve the control of the knee with weight-bearing activities. Your Physiotherapist can advise which exercises are most appropriate for the patient and when they should be commenced.
