ITB syndrome is one of the most common causes of lateral knee pain. (Pain on the outside of the knee).
The ITB, or iliotibial band originates at the hip and extends down the outside of the leg to insert at the outside of the knee.The ITB contacts the hip at the site of the greater trochanter and then again at the lateral aspect of the knee. At each site, there is a small sac called a bursa. Bursa are found all over the body at bony prominences and act to promote smooth motion over the area, similar to a pulley system. Muscle tightness can lead to increased friction which results in inflammation and pain along the lateral hip and knee.
This problem is one of the most common causes of lateral knee pain in runners and athletes. Woman are thought to be particularly prone to ITB syndrome because of their wider pelvis, affecting the angle of the femur (the thigh bone) in relation to the tibia (the shin bone). Pain usually begins shortly after the runner begins and persists as a burning or sharp pain on the outside of the knee , just above the joint line. Discontinuing the activity may relieve the pain temporarily, but constant irritation may lead to chronic pain in the area. Generally speaking, this pain is not associated with clicking, buckling or locking of the knee, which may be more suggestive of a tear to the meniscus or cartilage inside the joint.
Common causes of ITB include:
– Tight muscles
– Improper or worn out shoes
– Running down hill or on an embankment
Stretching and strengthening are an essential component of any treatment plan and an important part of preventative care. Strengthening the hip abductors, gluteals and core muscles are crucial to decreasing overall symptoms and preventing further injury.
– Start with some “relative” rest. Decreasing your running distance or take a short break all together. Try incorporating swimming or cycling into your routine. By cross training you will give the area time off while continuing to maintain your cardio and endurance training.
– Stretch your ITB and hamstrings!
– Use a foam roller on the lateral aspect of the hip over the belly of the muscle, not the bony prominence which may aggravate your symptoms. Try using daily for 2-3 minutes on both sides.
– Ice the lateral hip and knee for 5 minutes to each area daily and after activities.
– Begin an NSAID to reduce local inflammation
– Check your sneakers. Frequently, sneakers may be used only for working out so they may not seem “old or worn”. They do however tend to loose the internal support required to stabalize the foot. Execessive hyperpronation of the foot changes the angle at the knee joint and may stress the area contributing to your symptoms.
– Orthotics or shoe inserts may be beneficial.
– Injection therapy. Cortisone injections into the bursa can greatly reduce local inflammation and my be required as an adjunct to other treatments.
– Shorten your stride and increase your cadence.
Proper diagnosis is key to preventing further injury and ruling out other causes of knee and hip pain. If you are suffering from knee pain, make an appointment so we can get in on the right road to recovery and prevent further injury.