The iliotibial band is a very long, dense band of fibrous tissue running from the hip to the knee. Irritation of this band, common among runners and cyclists, is known as iliotibial band syndrome, or ITBS. There’s a curious aspect to ITBS: While it can cause significant pain on the outside of the knee, the root of the problem is more likely to be centered in the area of the tissue near the hip.

bikeIt is usually best to address ITBS as if it were an overuse syndrome, which it actually may or may not be. Follow the usual steps for an overuse injury: rest, ice, compression, elevation and anti-inflammatory medication. Part of treating ITBS can involve therapeutic stretching of this tissue.

Returning too soon to running, biking or other intense activity will likely make the problem significantly worse in the long term. So our first aim is to “calm down” the iliotibial band. Then we try to figure out why the problem manifested itself and how to prevent it from doing so again.

To that end, we focus on the following factors:

  • Core strength. Repetitive leg motions can destabilize your hip and knee joints if your abdominal, low back and pelvic muscles aren’t strong enough.
  • Hip muscle strength. Repetitive motion of weak hip muscles, such as the tensor fascia latae, to which the iliotibial band connects, can stress your knee tissues.
  • Iliotibial band contact points. For instance, once the bursa that normally acts as a cushion between the iliotibial band and the bony femoral epicondyle (an endpoint of the femur in the knee joint) becomes inflamed, the iliotibial band may rub against the bone, causing the band itself to be injured and painful.
  • Range of motion and form. Your body mechanics may need adjustment to ward off future iliotibial band issues.

We may recommend customized daily stretches of your iliotibial band to keep it strong and flexible. Please visit us quickly if you suspect you have an iliotibial band problem. We’ll evaluate your situation and determine a plan that is best for you.


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