The pain is typically proximal to the lateral joint line where the iliotibial band courses over the lateral femoral epicondyle lfe. The foam roller it band exercise is a great selfmassage exercise that will give your iliotibial it band the outsides of your thighs a deep and effective sports massage, thus improving the health and quality of your muscle tissue and helping you to perform better. The tighter the it band, the more likely it will rub on the femoral condyle and develop into pain. Falvey ec, clark ra, franklynmiller a, bryant al, briggs c, mccrory pr. Prospective study of the biomechanical factors associated. Heres what causes it, how to treat it, and how to prevent it. From the kaiser permanente anterior cruciate ligament. Rest, ice and the use of antiinflammatory medications may alleviate symptoms. Iliotibial band syndrome itbs is the result of inflammation. Iliotibial it band syndrome is a common cause of knee pain, especially in runners. This is an overuse injury, although direct trauma to the outer knee may cause the bursa to get inflamed.
It is frequently related to hip weakness and instability standing on one leg. It often occurs as a result of excessive tension of the band which rubs over the bony prominences of the thigh bone near the hip and knee. Mobility issues and myofascial restrictions are highly correlated with itbs. Iliotibial band itb syndrome itbs is the most common cause of lateral knee pain among athletes. Proximally, the iliotibial band provides an insertion for the tensor fascia lata and gluteus maximus muscles. It will also alleviate soreness and make your muscles feel better. Iliotibial band syndrome accounts for 12% of runningrelated overuse injuries 4. Pain at the lateral knee joint is the presenting symptom with point tenderness 12 cm above the lateral joint line. Iliotibial band syndrome is caused by excessive friction of the iliotibial band and the underlying bursa due to repetitive kneebending activities. Treat your own iliotibial band syndrome jim johnson on. Iliotibial band syndrome itbs is an overuse injury of the lateral knee that occurs primarily in runners and was first described in 1973. T2weighted mri showed higher signal in the enthesis of the iliotibial band itb along. Treatment program for runners with it band syndrome exercises should be completed at a separate time from a workout or run to gain maximum benefits and performed according to the following chart, everyday for 6 weeks. Iliotibial band itb syndrome is an overuse injury that results from constant friction of the itb over the lateral femoral epicondyle often seen in runners.
Fig 1 iliotibial band syndrome understanding the location and pattern of the pain and biomechanics is important to evaluate and treat the condition. Section editor karl b fields, md editorinchief primary care sports medicine adolescents and adults. If an exercise is painful, it may not be appropriate for your condition. The it band is a long tendon that extends from the outer side of the pelvis ilium and runs along the side of the thigh to insert just below the knee on the upper part of the shin bone. It happens too often to many runnersyou feel great and set out for an easy run, only to feel the twinge of illiotibial band syndrome itbs on the outside of your knee.
It causes pain and tenderness, especially just above the knee joint. Iliotibial band syndrome itbs the iliotibial band is the ligament that runs down the outside of the thigh from the hip to the shin, this ligament is attached at the knee and helps to move and stabilise the joint. Iliotibial band syndrome strengthening exercises it band pdf. A home exercise program that includes a flexibility and strength conditioning routine and modified training recommendations can aid in the treatment and prevention of further injury. Lay on foam roll on your injured side so that the roll sits under the side of the leg just below. If the foam roller is initially too painful, utilize a thera band roller. I have been under abnormalities acidbase imbalances associated with a popping sensation. Iliotibial band syndrome radiology reference article.
In conclusion, clinicians should consider knee synovial cyst as a differential diagnosis in patients presenting with recalcitrant iliotibial band syndrome. Evidence based treatment for iliotibial band friction syndrome. Iliotibial band syndrome is one of the leading causes of lateral knee pain in runners. Iliotibial band syndrome itbs is the result of inflammation and irritation of the distal portion of the iliotibial tendon see illustration as it rubs against the bursa. Iliotibial band syndrome treatment plantar fasciitis tips. How to treat runners knee iliotibial band friction syndrome with kinesiology tape duration. If you feel pain on the outside of your knee, you might have iliotibial band syndrome. Itbs develops as a result of inflammation of the bursa surrounding the itb and usually affects athletes who are involved in sports that require continuous running or. Iliotibial band syndrome brigham and womens hospital. Classically, iliotibial band syndrome is diagnosed by history and physical examination. Soft tissue injuries occur whenever force and strain are applied to muscles. Everything you need to know about it band syndrome including symptoms, prevention, solutions and exercises to relieve the pain. The iliotibial band is a fascial structure composed of dense connective tissue that assists stance stability and is capable of resisting large varus torques at the knee 7, 11, 12.
This article outlines how to diagnose itbs in someone presenting with lateral knee pain, and offers a practical guide to initial management in primary care. Mri results have shown thickening of the itb over the lateral. Iliotibial band syndrome it band syndrome is an overuse injury often seen in runners. Recommendations are made under the following categories.
Tightness in the it band or in the deep hip internal or external rotators is a contributing factor to itbs. This is an open access article distributed under the terms of the creative. Knee disorders guideline california department of industrial. The popularity of running is still growing and, as participation increases, the incidence of runningrelated injuries will also rise. Iliotibial band syndrome strengthening exercises it band. The iliotibial band is a band of fibrous tissue that runs down the outside of the thigh. Treating it syndrome generally includes a comprehensive approach, including the following. Similar to iliotibial band syndrome, excessive running can lead to irritation of the biceps femoris tendon insertion site causing pain on the outside of the knee. The ilitoibial band is a long band of tendon extending from the ilium to the knee. This information does not replace the advice of a docto. How to selftreat it band syndrome the physical therapy. You do what any good runner does in this situation. This is an open access article distributed under the creative commons attribution license, which permits unrestricted use, distribution, and. Each exercise listed after the first three should be.
Department of rehabilitation services physical therapy standard of care. In order to facilitate the evidencebased management of itbs in runners, more needs to be learned about. It provides stability to the knee and hip and helps prevent dislocation of. In the field of knee arthroplasty, itb traction syndrome has been reported following guided motion total knee arthroplasty, due to posterior femoral translation and internal tibial rotation during knee flexion.
Kaiser permanente national total joint replacement. A doctor may prescribe physical therapy if the initial treatment described above is. The iliotibial band is uniformly, firmly attached to the femur. The purpose of this three part study was to quantitatively analyze iliotibial band itb strain during movement in order to investigate the anatomical principles upon which a number of traditional treatments. The iliotibial band is a thick band of fascia on the lateral aspect of the knee, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. Iliotibial band syndrome itbs is a common injury in runners and other long distance athletes with the best management options not clearly established. In order to facilitate the evidencebased management of itbs in runners, more needs to be learned about the aetiology, diagnosis and treatment of this injury. Iliotibial band friction syndrome after knee arthroplasty. Iliotibial band syndrome is an overuse injury of the thigh and knee. Being an overuse injury, it is caused by repeated trauma rather than a specific incident. Itb syndrome feels like a sharp pain on the outer side of. Cross one leg over the other into a figure 4 position. When the leg is in a straight known as extended position, the band fibers are anterior to, or in front of, the condyle a bony.
Iliotibial band syndrome it band syndrome emedicinehealth. Iliotibial band syndrome iliotibial band syndrome itb is irritation to the tissue that lies over the outer side of the knee. However, this practice comes under question if the evidence from biopsies supports the lack of inflammation in the area. Itb syndrome iliotibial friction syndrome is one of the most common causes of runners knee and can account for up to 22% of overuse injuries in runners. In most cases of bunions are a iliotibial band syndrome treatment completely inverting or splints plantar fasciitis. The first three can be started immediately after the injury. Iliotibial band syndrome itbs or it band syndrome is an overuse injury of the tissues located on the outer part of thigh and knee. Review pmh, pertinent diagnostic tests, imaging and workup listed under lmr. Author jonathan jackson, md assistant professor of family medicine uniformed services university of the health sciences. The aim of this study was to assess the effect of antipronation orthotic insoles on pain and hip and knee kinematics in runners with overpronation and iliotibial band syndrome. It band mobilization with thera band roller massager. Treatment may involve antiinflammatory medications, physical therapy, ultrasound, massage, using a foam roller at the site of pain, and the use of orthotics.
Years of lifting, running, jumping, standing, and sports cause scar tissue to develop in muscles which affects performance and leads to knee tendinitis. Iliotibial band syndrome baptist health south florida. Iliotibial tract syndrome after cruciatesubstituting guided motion tkr. Pain develops where the iliotibial band itb courses over the lateral femoral epicondyle lfe, just proximal to the lateral joint line. Iliotibial band friction syndrome itbfs is an inflammatory, nontraumatic, overuse injury of the knee affecting predominantly longdistance runners. Iliotibial band syndrome it band syndrome topic guide. Pain over the tendon which is worse with activity and better with rest. Iliotibial band friction syndrome is an overuse injury of the iliotibial band, the broad tough band of fibres that runs down the outside of the thigh passing the knee. Illiotibial band syndrome protocol princeton university. It can become inflamed in people who overuse it, say in runners and cyclists. Often the deceleration of running down hills may lead to the excessive friction.
Iliotibial band syndrome itbs is the most common injury of the lateral side of the knee in runners, with an incidence estimated to be between 5% and 14%. Foam roller it band exercise golf loopy play your golf. It band syndrome itbs is the result of the large band that runs from your pelvis. Symptoms a snapping sensation over the knee whenever the knee bends. Iliotibial band itb friction syndrome is known to be one of the main causes of lateral knee pain related to an overuse injury. Data compiled from sandberg, kim, liu, torg, jonsson, donaldson, zarins, gelb, lee, and katz.
547 1192 1039 323 712 790 964 1351 969 1462 709 1107 512 504 73 737 26 1065 567 391 1623 431 1631 685 388 1245 581 597 292 530 473 76 584 34 217