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Home » First Aid, Injuries, Bites

ITB: Dealing With This Common Knee Injury

[11 Nov 2010 | No Comments | | Author: ]
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Male knee by David Shankbone
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Have you felt chronic pain in the outside of your knee? Or maybe you have hip pain. There are several possibilities and one is Iliotibial band syndrome, also called ITB.

Iliotibial band syndrome is a common sports injury that affects the knee of runners, bikers, hikers and weight lifters.

The Iliotibial Band is a tendinous extension of the fascia that covers from the lateral condyle of the tibia to the gluteus maximus; basically from the knee to the hip. The Iliotibial band provides support and stability and holds the pelvis to the lower leg.

Iliotibial band syndrome happens when the band becomes inflamed. This is commonly an overuse injury associated with runners, hikers, bikers and weight lifters.

There are training habits that increase your risk of developing Iliotibial Band Syndrome. If you are a runner exercising on a banked surface, inadequate warm up or cool down, increasing distance too quickly, downhill running or running the stairs can increase your risk of developing Iliotibial Band Syndrome.

Other abnormalities in the biomechanical expression of the foot and leg can also increase your risk. These abnormalities include over pronation, uneven leg length or bowed legs can also cause undue stress on the iliotibial band that will lead to over use and inflammation.

Those athletes who suffer from iliotibial band syndrome will experience irritation of the band and pain when the knee is flexed and then extended. This motion makes running or hiking difficult and painful. The athlete is often unable to point to a specific area that is painful but rather will use his whole palm over the lateral aspect of the knee. Runners notice that pain becomes worse as they run downhill and others find that sitting for long periods with their knee flexed results in increased pain.

Diagnosis of iliotibial band syndrome is based on a thorough history and physical. Some patients may benefit from an MRI which will show a pocket of fluid which is a result of the chronic irritation and inflammation under the lateral epicondyle, just over the outer knee.

Treatment of iliotibial band syndrome is based on the severity of the condition and the ability of the athlete to comply with the recommendations for treatment and rehabilitation. When the athlete is able to complete rehabilitation and correct the reason for developing the condition in the first place then the likelihood of developing the problem again goes down significantly.

Your physician will recommend rest, which means you stop the athletic activity which caused the issue. You will want to ice the area several times a day and as the pain decreases you will be shown sports massage to decrease the adhesions that can develop in tendons when inflammation has been present.

Low mileage recreational runners often respond well to anti-inflammatory medications, stretching, ice and rest. But competitive runners may need a more comprehensive approach to treatment. This can include corticosteroid injections if swelling continues to be noticed over the area 3 days after strict rest and anti-inflammatory medications have been started.

After the pain has been alleviated the athlete will begin stretching and strengthening the area to prevent this problem from happening again. The gluteus medius muscle is an important muscle to strengthen in this process.

Surgical treatment may be considered for those athletes in whom a more conservative approach hasnt been successful. Surgical intervention is usually not necessary when the athlete recognizes the pain as a signal they should rest the area and treat it. An early diagnosis and treatment increases the probability that athlete will respond well to anti-inflammatory medications, rest, ice, stretching and strengthening.

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