Written by Physiotherapist, Michael Tegerdine. Michael specialises in sport injuries and musculoskeletal rehabilitation.
The effects of Iliotibial Band Syndrome (ITBS) can range from a mild twinge to debilitating pain. Its early identification is important in order to prevent it becoming a chronic problem. ITBS is a common cause of hip and knee pain in people who perform sports with repetitive actions such as running, cycling and racket sports.
The Iliotibial band is a very strong fibrous tissue, which starts at the outside of the hip and goes down the outside of the leg, inserting below the knee at the outside aspect of the shinbone. During knee movement the iliotibial band works with the quadriceps to aid stability. Stability is required for effective knee control in activities such as running, squatting and lunging.
What is it?
The iliotibial band repeatedly rubs over the outside of the knee, causing friction / tissue irritation (inflammation). The iliotibial band can be thicker at the knee and fluid can build underneath itself. The inflammation and swelling causes pain.
How do I know if I've got it?
Symptoms include a sharp or burning pain over the outside of the knee. This can occur while lunging, changing direction or when running for the ball. Symptoms can be more severe 24 to 48 hours after training or a game; this is often felt as a deep ache pain down the outside of the leg(s).
ITBS and Squash players
The repetitive nature of the lunge in squash can cause excessive pelvic tilt, which in turn can stress the iliotibial band. Changing direction, depth and speed of the lunge, rapidly and repeatedly can put players at risk for ITBS.
- Overtraining / changing training suddenly
- Poor biomechanics
- Weakness in the gluteal muscles
Treatment Physiotherapy can help treat ITBS, this can include:
- Tissue mobilisation (soft tissue massage / myofascial release)
- Biomechanical correction (function of the pelvis, hip and knee)
- Activity modification
- Stretching and strengthening exercise prescription
- ITBS education
- Advice on footwear
- Advice of sport specific warm up and cool down
- Injury prevention strategies
Three steps to dealing ITBS
- Visit your GP to rule out any non-sport causes
- Consult a physiotherapist
- Follow a structured management and treatment programme
**Disclaimer: This article is for general information only and should not be used as a basis for diagnosis or treatment**