Knee pain ITB Syndrome Pain outside of the knee Runners Knee Pain when Cycling Pain when Running
Pain in the knee is a very common complaint we have in the clinic, and often its not anything major. With some modifications made to everyday activities and/or exercise this most of the time will go away within time.
Today we will specifically look at a condition that may affect some runners, cyclists, walkers and hikers, called Iliotibial Band Syndrome. But before we dive into what it is, lets take a look at what it is made of, and what its job is.
What is the ITB
The IT Band is made up of multiple layers fibers that connect the hip to the knee and outside of the shine bone, therefore it also acts as a lateral knee stabilizer (so why on earth would we want to stretch it?). It also acts as a location for muscles to attach onto, e.g the glutes and the TFL.
Causes of ITB Syndrome:
Are mainly repetitive movements of repeatedly bending the knee, activities such as cycling, running, walking/hiking can aggravate or bring on this condition. Part of the ITB Syndrome is also due to the friction of the IT Band and the lateral condyle of the Femur/Tibia (Outside bony part of the thigh bone where it connects to the shin bone). If the IT is too “tight” this can cause compression over the bursa causing friction over the site. The bursa – a fluid filled sac, helps to reduce the drag over the IT Band and the bone. The IT Band and the bursa can both start to get inflamed causing pain and discomfort at the site, leading to ITB Syndrome.
FUN FACT…The IT Band CANNOT!
Be stretched, no amount of stretching, rolling, massage, use of tools, chiropractic adjustment, physio sessions, massage guns, snake oil (you get the idea) can lengthen this band. It would require the weight of a small car to to lengthen the band by JUST 1%, and when the weight is removed it will go back to the original length.
SO HOW DO WE REDUCE “TIGHTNESS” YOU ASK?
A few ways we can do this, patient depending of course, but typically I would look to see what the adjoining soft tissue structures are doing, is it real tightness, or is it simply the sensation of tightness? We can do a few tests in clinic to give us an impression of what it may be, depending on what we find through the case history and physical examination will depend on the treatment used. But typically we would look to educate, modulate pain, and build up tolerances/capacity of the area if we find any “weaknesses” or “tightness”.
WHAT MAY BE CAUSING IT?
Training errors can also contribute to suffering from ITB Syndrome, some factors could include doing too much too soon than you are conditioned for, pushing too hard, increasing of time, frequency and reduced rest. Extrinsic factors may also include worn out footwear, change of running surface, running on banked surfaces and running downhill. Some intrinsic factors may also include bowed legs, knee arthritis, weakness in associated muscles such as quads, hams, glutes and TFL and having a Leg length discrepancy, although must be noted that problems don’t really arise until a discrepancy is greater than 2.5cm.
Symptoms: Usually an isolated pain outside the knee isolated to one location. Pain may be mild at first, and above the joint line on the outside of the knee, on the bony rounded knuckle of the knee. At around 30 degrees of knee flexion the IT Band passes of the femoral condyle, pain at this degree of flexion could be an indication that you may have ITB Syndrome.
Sound like something you may be experiencing? Get in touch and see if we can help you!