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Concept
Iliotibial band syndrome
Summary
Iliotibial band syndrome (ITBS) is the second most common knee injury, and is caused by inflammation located on the lateral aspect of the knee due to friction between the iliotibial band and the lateral epicondyle of the femur. Pain is felt most commonly on the lateral aspect of the knee and is most intensive at 30 degrees of knee flexion. Risk factors in women include increased hip adduction and knee internal rotation. Risk factors seen in men are increased hip internal rotation and knee adduction. ITB syndrome is most associated with long-distance running, cycling, weight-lifting, and with military training.
ITBS symptoms range from a stinging sensation just above the knee and outside of the knee (lateral side of the knee) joint, to swelling or thickening of the tissue in the area where the band moves over the femur. The stinging sensation just above the knee joint is felt on the outside of the knee or along the entire length of the iliotibial band. Pain may not occur immediately during activity, but may intensify over time. Pain is most commonly felt when the foot strikes the ground, and pain might persist after activity. Pain may also be present above and below the knee, where the ITB attaches to the tibia.
ITBS can result from one or more of the following: training habits, anatomical abnormalities, or muscular imbalances:
Training habits
Spending long periods of time/regularly sitting in lotus posture in yoga. Esp beginners forcing the feet onto the top of the thighs
Consistently running on a horizontally banked surface (such as the shoulder of a road or an indoor track) on which the downhill leg is bent slightly inward, causing extreme stretching of the band against the femur
Inadequate warmup or cool-down
Excessive uphill and downhill running
Positioning the feet "toed-in" to an excessive angle when cycling. (Knee should be positioned between 30 and 35 degree to help avoid ITBS)
Running up and down stairs
Hiking long distances
Rowing
Breaststroke
Treading water
Abnormalities in leg/feet anatomy
High or low arches
Supination of the foot
Excessive lower-leg rotation due to over-pronation
Excessive foot-strike force
Uneven leg lengths
Bowlegs or tightness about the iliotibial band.
Official source
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