IT Band Syndrome by Sandra Augustin

Team Sandra Augustin

The Iliotibial Band (ITB) is a thickening of the fascia or the outer casing of the muscle (like the casing of a sausage) that runs along the outside of the thigh.  It originates up by the top of the hip and ends on the outside of the knee.
Although the most common pain caused by ITB Syndrome is knee pain, the Gluteus Maximus and the Tensor Fasciae Latae (TFL) are the two main muscles that are addressed when dealing with ITB syndrome.  Because the ITB originates at the hip, these surrounding muscles play a large role in the cause and recovery of this injury.

Signs and Symptoms
-Lateral (outside) knee pain - NOTE- very few conditions, other than a ligament sprain, will present as lateral knee pain therefore this alone is often diagnostic.
-Pain is often worse after running, especially after climbing hills and often aggravated by climbing stairs
-Pain may not be present until mid-way through a run, often not until climbing a hill
-Pain can literally bring a runner to his/her knees
-Sometimes associated with a 'snapping hip', in which the muscles that cross the outside of the hip can be felt to snap or click during walking or running.
-Pain may also present as lateral thigh pain more so than knee pain but is rarely focused primarily in the hip or gluteal muscles.
-Can often be attributed to some form of over-training - doubling one's mileage, sudden increase in hill repeats, etc.

What's Going On
The lateral knee pain is generally caused by the ITB pulling upward on its site of attachment (knee) by the TFL and/or Gluteus Maximus muscles. Underneath the ITB, near its insertion at the knee, is a fluid filled sac called a bursa, which is designed to lubricate areas where rubbing and friction occur. However, when the ITB gets excessively tight, it puts too much pressure on the bursa and the bursa reacts by becoming inflamed, swollen, and painful.

What To Do About It
-Reduce or stop running (especially hills) until pain has disappeared; however, you must continue to maintain fitness with any other activity that does not increase symptoms
-Use ice over outside of the knee when pain is severe
-Stretch the Gluteals and TFL muscles  
-Self-massage over the outside of the thigh, or deep massage of the gluteals and hips
-Proper running shoes and/or sport orthotics
-Gradually return to running on flat, even terrain

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