ITB KNEE PAIN OR ILIOTIBIAL BAND PAIN

ITB Knee Pain is the second most common knee presentation that impacts runners behind runner’s knee. It is typically localised pain on the outside aspect of the knee and is increased with running at higher speeds and/or downhill. The ITB is a thick piece of connective tissue that runs down the outside of your thigh and has many attachments at the knee and pelvis. The role of the ITB is to assist in the control and of the knee and hip during tasks such as standing, walking and running.

Causes of ITB Knee Pain 

It was previously thought that ITB pain was caused by “friction” from a tight ITB. Now, it is more understood as compression of highly innervated fat tissue between the ITB and femur. 

The ITB often becomes irritated when under excessive stress, which can be attributed to any combination of increased/varied training load, poor recovery, change in shoes, poor nutrition & hydration, or lack of sleep

Clinical Presentation of ITB Knee Pain

• Localized pain on the outside of the knee

• Aggravated by high-speed running and downhill activities. 

• Walking down stairs commonly painful

• Pain that get worse with exercise, does not warm up

• Common pain description, “Feels like a knife in the side of my leg”.

Why is Stretching Not Necessarily Beneficial?

When health professionals thought the problem was a “TIGHT” ITB, they would commonly encourage aggressive stretching or foam rolling. However, both these modalities can aggravate the ITB further as they increase compression on already irritated fat tissue. Furthermore, to loosen the ITB, it would require 400kg of force before a 1% change in length which would only last a few mintues. 

Management Strategies for ITB Knee Pain

1. Manage Load

   Reduce or modify aggravating activity 

2. Improve Tissue Capacity 

   Heavy slow resistance training to the gluteal muscle groups, anterior hip and quadriceps.

3. Address Movement Pattern or Biomechanics

   Addressing a low cadence or narrow stance when running can decrease the load on the ITB

4. Graded Introduction to Plyometrics

   Plyometrics develop the spring of the ITB. This makes it more resiliant and powerful.

5. Graded Return to Running

Get Professional Help for Medial Tibial Stress Syndrome

We have physiotherapy clinics in Clovelly, Coogee, and Manly, as well as in London, so come and see us in person or if you are anywhere in the world, access us via an online physiotherapy consultation that we have specifically developed to assess and treat runners anywhere in the world with great success.

Lastly, Alex and Pat sat down with Nuzest team and gave their one-minute insight into ITB related knee pain. So please give the below video a listen. 

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