Post by Dr Marybeth Crane
If you have just started running, you probably have no thought what an iliotibial band is, let alone where it is in your body. If you have been running for years, you fondly refer to it as your "IT band". This is a very commonly irritated location in a distance runner's body. Certainly a top ten injury contender!
So what and where is your IT band? It is a fibrous band that runs on the outside of your thigh and attached to the hip at the top and to the outside of just below your knee at the bottom. The central feature of this band is a very essential muscle, the tenor fascia lata. Most anatomy books describe the TFL as a hip abductor. Genuinely, this is a key muscle that controls and decelerated the adduction of your leg in gait. A quite critical portion of running unless you like your leg flapping about and like to run like a ballerina! This control equates to an eccentric load on this muscle and band at least 90 times a minute whilst running. Quite tense and overworked region in a runner! No wonder it likes to complain from time to time!
What does ITB syndrome feel like? A huge pain in the knee! But seriously, a discomfort that usually starts following an intense workout in the outside of your knee. It can radiate from your outer hip down towards your knee as well. The pain is typically pretty sharp and starts soon after a couple of miles into your run. This injury does not "warm up" like most tendon injuries. It gets worse when running downhill or on uneven surfaces. It generally will persist until you quit and walk. In the early stages, the pain goes away when you quit running. A mild amount of swelling on the outside and below your knee can happen. Some individuals will even have some tingling down the outside of their lower leg. If you continue running with this injury, it can get really debilitating to the point that the discomfort only goes away when walking with your knee locked in a stiff legged manner.
Why do runners get ITB syndrome? Too a lot, too soon, too quick syndrome is the simple answer but this is not just an overuse injury. Several runners who run only short mileage can suffer ITB syndrome. This is typically due to a mixture of weakness in the tensor fascia lata and other hip abductors, and lack of flexibility of the IT band. Couple this with a fondness for running on the same side of the road or around an oval track bow legs, a leg length discrepancy and an excessively mobile flat foot or flexible high arched foot type and you have IT band syndrome!
How is ITB syndrome diagnosed? There is a particular test for ITB syndrome known as the "Noble compression test". The test is performed by the physician placing their thumb over the lateral epicondyle of your upper leg and then you flex and extend your knee. If you tend to jump off the table when at about 30 degrees of knee flexion then you most likely have ITB syndrome. Why? When your leg is straight, the ITB is in front of the epicondyle in knee flexion, the ITB actually passes over the lateral epicondylar surface. If your ITB is inflamed, the friction caused by this motion is quite painful, specifically when your doctor is compressing the ITB on the bone. An at home test that is similar is to stand with all your weight on your painful leg and flex the knee to about 30 degrees. If you have ITB syndrome, you will really feel discomfort with compression to the outside of your knee.
What are the finest treatments for ITB Syndrome? The very first line treatments are relative rest (yes, that indicates slow down and remain off of hills and uneven surfaces), icing, anti-inflammatories and lots of stretching. But don't forget, it is a combination of weakness and lack of flexibility as properly as instability so stretching is almost by no means enough. Lots of men and women have ITB syndrome and just rest until is stops hurting, just to rear its ugly head when you start running once more! You have to get to the root of the problem! Strengthening of gluteus medius, as well as the other hip abductors is an vital part of the rehabilitation of ITB syndrome. You also require to treat any excessive foot pronation, supination or leg length discrepancy. Custom orthotics are frequently needed for lengthy distance runners.
Bottom line, ITB syndrome can be really the persistent pain in a runner's knee. This pain typically lingers for months and even years simply because of treating the symptoms and not the root of the problem! Stretching, strengthening and control of instability are key components to the successful rehabilitation of this common injury.
About the Author
Dr Marybeth Crane is a life-long runner and a sports medicine podiatrist. For a copy of her Free BOOK or far more details on running injuries or for physician-approved foot care products, pay a visit to my web site http://www.myrundoc.com or read my blog at http://www.myrundoc.blogspot.com
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