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Iliotibial Band Syndrome Physiotherapy
Iliotibial band syndrome (ITBS) is one of the most common causes of knee
pain, particularly in individuals involved in endurance sports such as
- running (including athlons like biathletes and triathletes)
In fact, ITB
accounts for up to 12% of running injuries and up to 24% of cycling
Iliotibial band syndrome is typically managed conservatively with physical
therapy and temporary activity/exercise modification.
first of all, What is Iliotibial Band Syndrome (ITBS)?
Iliotibial band syndrome (ITBS) typically happens when excessive irritation causes
pain at the outside (or lateral) part of the knee.
The iliotibial band
(ITB), often called as the "IT band" is a type of soft tissue that
runs along the side of the thigh from the pelvis all the way to the knee.
As it nears and approaches the knee, its shape thickens as it crosses a prominent area
of the thigh bone (the femur), called the lateral femoral condyle.
At or near the
pelvis, the ITB attaches to 2 important hip muscles, the tensor fascia latae
(TFL) and the gluteus maximus.
Irritation and inflammation arise from friction between the ITB and
underlying structures when an individual moves through repetitive
straightening (extension) and bending (flexion) of the knee.
Most of the time, iliotibial band syndrome pain happens with overuse during activities such as running and
ITBS involves many lower extremity structures, including muscles, bones, and other soft tissues, the number #1 discomfort arises from:
- Abnormal contact between the ITB and thigh (femur) bone
- Poor alignment and/or muscular control of the lower body
- Prolonged pinching (compression) or rubbing (shearing) forces during repetitive activities
The common structures involved in ITBS are:
- Iliotibial band
- Bursa (fluid-filled sack that sits between bones and soft tissues to limit friction)
- Hip muscles
ITBS typically occur in but is not limited to:
- Athletes who performs repetitive activities, such as squatting
- Atheletes who participate in endurance sports such as running and cycling
- Individuals who spend long periods of time in prolonged positions,
such as sitting or standing for a long workday, climbing or squatting,
- Individuals who quickly start a new exercise regimen without proper warm-up, transition or preparation
Signs and Symptoms
With ITBS, you may experience:
- Stabbing or stinging pain along the outside of the knee
- A feeling of the ITB “snapping” over the knee as it bends and straightens
- Swelling near the outside of your knee
- Occasionally, tightness and pain at the outside of the hip
- Continuous pain following activity, particularly with walking,
climbing, or descending stairs, or moving from a sitting to standing
ITBS pain is usually most intense when the knee is in a slightly bent
position, either right before or right after the foot strikes the
ground as this is the point where the ITB rubs the most over the femur.
How Is iliotibial band syndrome Diagnosed?
Our senior physiotherapist will ask you questions about your medical
history and activity regimen.
A physical examination will be performed
so that we can collect information on
- movement (range of motion)
- flexibility measurements at the hip, knee, and ankle
When dealing with ITBS, it is also common for our senior physical therapist to
use special tests and complete a movement analysis, which will provide
information on the way that you move and how it might contribute to your
This could include assessment of
- walking or running mechanics
- foot structure and
We may have you repeat the
activity that causes your pain to see firsthand how your body moves when
you feel pain. If you are an athlete, we might also ask you
- chosen sports, activities or exercises
- shoes you wear for training
- training routes and
- exercise routine
Typically, medical imaging tests, such as x-ray and MRI, are not needed to diagnosis ITBS.
how our senior physiotherapists can help you
We will use treatment strategies to focus on:
Range of motion
Often, abnormal motion of the hip and knee and foot joint can cause
ITBS because of how the band attaches to hip muscles. We
will assess the motion of your injury leg compared with expected normal
motion and the motion of the hip on your uninvolved leg.
Hip and core weakness can cause, aggravate and contribute to ITBS.
The "core" refers to
the muscles of the abdomen, low back, and pelvis. Patients need to note that core strength is
important, as a strong midsection will allow greater stability through
the body as the arms and legs go through various motions.
performing endurance sports, it is important to have a strong core to
stabilize the hip and knee joints during repetitive leg motions. We will be able to determine which muscles are weak and
provide specific exercises to target these areas.
Our senior physiotherapists are trained in manual therapy, which means
they use their hands to move and manipulate muscles and joints to
improve motion and strength. These techniques can target areas that are
difficult to treat on your own.
We may also use the following:
Even when an individual has normal motion and strength, it is
important to teach the body how to perform controlled and coordinated
movements so there is no longer excessive stress at the previously
We will develop a functional
training program specific to your desired activity. This means creating
exercises that will replicate your activities and challenge your body to
learn the correct way to move.
We will also work with you to develop an
individualized treatment program specific to your personal goals. We will offer tips to help you prevent your injury from reoccurring.
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At the first session, our specialist physiotherapists will carry out a thorough
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Follow up sessions are inline to provide
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