Iliotibial Band Syndrome
Iliotibial band syndrome is also known as IT band friction syndrome or runner's knee. The iliotibial band is a fibrous ligament that runs from above the outer hip to the outer knee. Inflammation can occur under the bottom portion of this ligament around the knee and occasionally higher up around the hip in a fluid filled bursa sac call the subtrochanteric bursa. Runners and cyclists commonly experience this condition and typically notice a gradual onset with symptoms being most pronounced when running or walking up or downhill. Occasionally people report "snapping hip" syndrome from the ligament rolling across the area of bursitis.
IT band syndrome is normally caused by predisposing biomechanical faults in the pelvis or feet. Global movement patterns of the whole body must be evaluated. Treating only the area of pain is an ineffective approach. The most common cause is an unbalanced pelvis that leads to slight changes in the angles the muscles are pulled at. The altered angles of pull lead to increased friction which ultimately causes inflammation and pain. When the pelvis is not balanced, the glute medius and hip abductors may be weak and neurologically inhibited. This causes recruitment of secondary muscles leading to hyperactive adductors. The whole imbalance can lead to IT band syndrome.
When the feet are the primary cause of runner's knee, the main problem is hyper-pronation of the foot on the affected side. As the arch drops, the tibia rotates internally pulling or tractioning on the IT band. Hyper-pronation can be caused from weakness or and proprioceptive deficits in the peroneal muscles as a lasting effect of a prior ankle sprain.
Large increases in distances or intensity can bring on IT band syndrome. Being bow legged and running on an unleveled or cantered surface can be contributing factors as well. Since runner's knee is a repetitive stress injury, initial treatment approaches typically involve rest, ice and anti-inflammatory products. If the condition is due to a biomechanical imbalance, rest will help in the short term but ultimately the pain will return. Stretching the gluteal muscles and TFL, Epsom salt baths and tapering down the distance and intensity can provide short term relief. Ignoring the pain and continuing training can cause the condition to become so inflamed that a cortisone shot may be necessary.
Long term solutions for IT band syndrome center around correcting the biomechanical imbalances in the pelvis and feet. Most people respond well to chiropractic care because chiropractic adjustments can re-balance the pelvis. Massage techniques to release trigger points in the gluteal muscles and foam rolling the TFL and IT band are useful. Stretching the adductor muscles and using a cold laser over the inflamed tissue can accelerate healing. Good running shoes and custom orthotics can help correct imbalances in the feet and lead to long term solutions.
If you live in the Frisco, TX area and are suffering with IT band syndrome, contact Frisco Spinal Rehab today for a full evaluation. The chiropractors and massage therapists at our family chiropractic center in Frisco have years of experience helping people recover quickly from this condition and getting them back to full activities as soon as possible.