The ABC's of the ITB
Iliotibial band syndrome ITBS
The iliotibial band ITB is the long ligament that runs from the hip to the knee, it is designed to help stabalise the knee and aid in movement. If there is a problem with the ITB, the knee on movement will be extremely painful (especially running). The symptoms are sharp burning pain on the lateral side of knee, swelling of knee. Pain on bending knee.
How you can diagnose ITBS?
How to diagnose ITBS, you can bend your knee 45 degree angle and if it produces pain on the lateral (outside) side of knee you have a problem. You can have a MRI performed and this will show a thickening of the band which is from the inflammation.
Why does it happen?
Any movement that makes the leg turn inwards. Running in worn out shoes, not having proper support for arches. Running on angled surfaces (like the side of the road), running downhill, if you run the same direction on a track even putting a lot of kilometres on your feet. Women tend to be more prone due to there hips tilt in a way that creates the knee to turn in. Weak core, hip, gluteal muscles and inner quadricep muscles, The band where it attaches to the knee narrows and travels over bone of the knee, this can rub and create inflammation.
What can be done to prevent ITBS?
When you first start to feel the niggle in the lateral aspect of the knee, decrease the kilometres that you are running, try and give yourself a couple of days off your feet.
Longer warm up before a run.
Replace worn shoes, especially if worn on the outside of sole.
Do not run on hard surfaces
Check if you need orthotics
When increasing your distance it should be done in 10% increments.
Treatment
Rest. The best treatment to start with is rest. If you continue to run than it has the potential to become a chronic problem instead you can try swimming, cycling or cross trainer to maintain fitness.
Anti-inflammatories are beneficial at this stage to help clear the inflammation around the friction zone.
Massage or myotherapy to release tightness and relax the muscles.
Acupuncture is beneficial in reducing pain and relieving the inflammation.
Stretching the muscles that are around the outside of the hip. Foam roller on the gluteals, ITB and the quadriceps will help loosen any knots.
Exercises to rehabilitate the band such as clam, heel drops and hip abductors.
Below I have included strengthening exercises from the runners world
Strengthening can begin when the following exercises are performed painlessly.
Lengthening Stretch
The most effective lengthening exercise for the ITB is to stretch it across the hip and outside of the leg. Cross the injured leg behind the other leg and lean toward the uninjured side. First stretch with your arms over your head, creating the shape of a bow from ankle to hand with the injured ITB outside, then bring your arms down to touch the ankle on the inside of the bow. The runner’s right leg is being stretched in image above. Hold the pose for 15 seconds and repeat 10 times. Perform three sets a day.
Clam Shell
Begin with a clamshell exercise using a resistance band. Perform the exercise slowly with emphasis on good form. Build up to 10 repetitions of three sets on each leg. When this exercise becomes easier and the leg remains pain-free during the process, you can move on to more advanced strengthening.
Side Leg Lifts
Lying on your side, raise your top leg straight up, then pull the leg back in that plane, move it forward and return it to the starting position. Form is very important. Check that you have a straight line from shoulder to ankle with the top hip slightly in front. (Do not let the top hip rotate backward.) Perform the sequence slowly with toe pointed down. Build up to three sets of 10 repetitions for each leg.
Single leg Squats
Balance on one foot, then bend your supporting knee to lower your torso one-quarter of the way to the ground. Take care that the knee stays straight over the foot and does not collapse inward.
After you have mastered the straight quarter squat, make the exercise more challenging by mimicking running form, extending the unsupported leg behind you and bringing it through to lift the knee in front of you. Ultimately, move farther by touching the ground in front of your body on the forward lean.
While standing on your right foot, move a soccer ball up and down diagonally from lower left to upper right, then side to side in a twisting motion. Repeat with the left foot, moving the ball from lower right to upper left.
Hip Hikes
When strong enough, eccentric strengthening works the hip abductors in the same manner in which they function during running. Standing on one foot on a step or a stair, raise the other foot by lifting your hip on that side, while taking care to stay in a straight, upright position. Slowly lower the hip to the bottom of your range of motion, while staying upright. Perform 10 repetitions on each side and build up to three sets.
Hope this bit of information helps and as always if you need any advice please do not hesitate to call on 5310 6259 or book online at www.bodyandspinesolutions.com.au.
Where movement never felt so good
Rachael
