Iliotibial Band Friction Syndrome (ITBFS) – What is it?
ITBFS is one of the most common causes of “Runner’s Knee”, generally caused by repeated trauma rather than a specific incident.
The ITB is a long, thin band of fascia that runs down the outside of your thigh. At the top of your thigh it is attached to your Tensor Fascia Latae (TFL) and Gluteus Maximus muscles, and at the bottom it attaches to your tibia (the bigger shin bone) and femoral condyle (thigh bone).
With movement (Eg Running), the ITB slides forwards and backwards across the outside of the knee. This repetitive sliding can create excessive friction, irritating the structures over the outside of the knee, producing the pain known as ITBFS.
What Predisposes Runners to ITBFS:
Essentially ITBFS is caused by altered running biomechanics due to underlying muscular imbalances. These imbalances can be caused by a variety of factors, including:
– Poor running technique/biomechanics
– Poor lateral hip Stability and Control
– Weak lateral hip muscles
– Weak deep hip rotators
– Quadriceps imbalance
– Weak/Poor control of Core musculature
– Other Muscular tightness or weakness
– Foot Arch and Foot Mechanics
– Shoe Choice / Shoe Mileage
– Training Overload
– Training Terrain
– Biomechanic alterations with fatigue
Symptoms:
– Pain located on outside of knee
– Localised knee swelling
– Pain running/walking which is worse down hills
– Pain worsens with exercise
– Pain with particular knee angle during running
Diagnosis:
Diagnosis if ITBFS is generally made following clinical examination. More importantly, the underlying cause/s need to be identified, as this is what needs to be changed in the long-term to prevent ongoing issues.
Early Diagnosis is key for minimising time away from training.
Treatment:
Treatment of ITBFS at Ferry Rd Physio involves manual therapy to help resolve the current symptoms that are present, the construction of a rehabilitation program to target the underlying cause of the ITBFS symptoms, and modification of training load for a graduated return to full running. If you have a coach or trainer, we can also discuss modifications with them.
Once symptoms have settled, we like to perform a running gait analysis to help identify any potential biomechanical issues with your running that may be missed with other clinical examinations. We can then use this information to further correct biomechanical factors, provide running drills that focus on these specific areas that need improving, to get you back running more efficiently and injury free!
Happy training
Adam Imer
Co-Director and Physiotherapist
Ferry Rd Physio