The iliotibial band(ITB) is a thickening of tissue under the skin of your thigh, extending from the outside of the hip to just below the outside of the knee. In active people, such as runners, cyclists, and in-line skaters, this structure can cause lateral knee pain, with no apparent injury. Due to the fact that no trauma has occurred, many individuals struggle with this problem for long periods of time.
With every bend and straightening of the knee, the ITB rubs over the outside of the knee. In the vast majority of cases, this never causes a problem. However, certain situations can lead to pain. Some people, because of leg alignment, tightness in the ITB, muscle imbalances, and even foot problems will develop knee or thigh pain related to their ITB. Muscle imbalances occur when one group of muscles become either over or under-developed. Running on a banked track or on the shoulder of a road can cause stretching of the band against the outside of the knee. The band itself, and/or the outside of the knee can become irritated. In addition, inadequate warm-up and cool-down may also overwork the iliotibial band.
The pain associated with an ITB problem may develop gradually, or “come out of nowhere”. Most often, the pain is just above the outer side of the knee, but it may also be present all along the outer side of the thigh. Sometimes swelling is present at the spot where the band rubs over the outer side of the knee. The pain is usually not constant, but brought on by certain activities or positions.
Treatment of ITB problems often includes stretching of the band and its associated muscles. Runners may have to decrease their mileage or change their running route, to avoid too much running on the same banked surface. Cyclists may need to temporarily change their seat height. Ice and anti-inflammatory medication may be used to relieve symptoms. Once the problem is diagnosed, ultrasound, infrared or cold laser and advanced stretching techniques are often applied by physical therapists or athletic trainers. In addition, motion-control running shoes or a shoe orthotic may be recommended, to level out how the foot hits the ground. In many cases, we have found success by teaching specific exercises to improve strength from the hip down to the foot, thus creating greater stability and eventually eliminating the pain completely. In very rare cases, surgery(by an orthopedic surgeon) may be needed to solve this problem.
