Then stop running… and do something about it!
ITB syndrome is one of the most common and often frustrating running related injuries. It ‘s also the most common cause of exercise induced knee pain. Luckily it’s easily treated if diagnosed and treated early, before it becomes chronic. If someone has faulty pelvic mechanics the muscles that attach to the pelvis will not work as efficiently. Over time, without appropriate correction they become tight and cause pain, often in the knee.
What is the ITB?
The Illiotibial band (ITB) is a thickening of the fascia or outer casing of the muscle that runs up the outside of the thigh. It originates up by the top of the hip and ends on the outside of the knee.
What causes ITB Syndrome?
ITB Syndrome, or Lateral Knee Pain is caused by the ITB shortening and pulling up on it’s insertion on the outside of the knee. Located under the ITB near its insertion is a bursa, a fluid filled sac that lubricates areas where rubbing and friction occur. When the ITB is pulled tight it creates pressure on the bursa. It reacts by becoming inflamed, swollen and often painful.
The ITB can be pulled tight by the TFL or the Gluteus Maximus. Running up hill uses more of the glutes than running on flat ground and therefore can tighten your ITB. It can also be aggravated by running on uneven surfaces, on tight indoor tracks, running in poor quality shoes or if your foot pronates.
How do I know if I have it?
Do any of the following relate to you:
- Pain on the outside of the knee
- Knee pain that is often worse after running, especially climbing hills or stairs
- Pain that commences midway through a run
- Pain that is severe enough to make you stop running
- A ‘snapping hip’ where the muscles that cross the outside of the hip can be felt to snap or click during walking or running
- Pain in the lateral thigh rather than the knee
- Minimal recovery stretching following exercise
How do I fix it?
Address any faulty pelvic mechanics by visiting a Physiotherapist or Exercise Physiologist. Make sure you choose a functional movement specialist. Find one here.
Strengthen weak pelvic stabiliser muscles. Any abdominal work helps ie situps but targeted exercises that engage the transverse abdominals as well are best.
Modify or stop running (especially up hills) until the pain has disappeared.
Rest and ice the outside of your knee for 20 mins with an Ice Mate when pain is severe.
Use a slow creep rolling technique over your lateral thigh with a Footeez but beware. It’s brutal but it’s also the most effective way to reduce ITB tightness.
Assess and correct faulty foot mechanics (pronation) by seeing your Podiatrist for orthotics.
Get the right pair of running shoes for your foot.
Return to running slowly. Correcting poor mechanics can take up to six weeks to see effective change. You need to be both patient and committed to the recovery process.
Creep rolling Vs Foam rolling
These days foam rolling is almost universally accepted as a recovery technique for releasing tight fascial bands, especially in muscles of the upper thigh, lower leg and back.
But there is a much more effective rolling technique that is used by elite athletes to maintain the joint mobility they need to be able to regularly perform at their peak. It’s called Creep rolling. It find out more read: Creep Rolling – Foam Rolling on Steroids