ITB pain is pain experienced along the lateral aspect of the thigh. The iliotibial band is an anatomical structure that crosses both the hip and knee joints. The structure originates from the top of the pelvis, traverses down the side of the femur bone, and attaches just below the knee joint into the the side of the tibia bone. It is an important stabilising structure of the lateral part of the knee during flexion and extension.
Inflammation and irritation of the iliotibial band can occur as it travels back and forth, crossing the bony prominence of the thigh bone as the knee flexes and extends. Iliotibial band syndrome is the name given to the overuse injury that describes pain on the outside part of the leg especially during running when the heel strikes the ground. It is the most common cause of lateral knee pain in runners and cyclists and also appears regularly in athletes who repeatedly squat.
Towards the upper part of the ITB, is formed the tensor fascia lata muscle (TFL). ITB pain or Iliotibial band syndrome [ITBS], may be multifactorial in aetiology – including poor training habits, poor flexibility of muscles, and other mechanical imbalances in the body, especially involving the lower back, pelvis, hips, and knees.
There can be a predisposition to develop ITBS. Anatomy issues may include differences in the lengths of the legs (a leg-length discrepancy), an abnormal tilt to the pelvis (AS or PI), or genu varum (bow-legged). These situations can cause the iliotibial band to become excessively tight, leading to increased friction and irritation when the band crosses back and forth across the femoral epicondyle during activity.
Training errors may cause runners to develop ITBS symptoms. Many roads are cambered, with the centre of the road higher than the outside edge to allow for water runoff. If a runner always runs on the same side of the road, it produces the same effect on the body as having a leg-length discrepancy. One leg is always downhill compared to the other, and the pelvis tilts to accommodate the activity. Excessive hill running training can also cause inflammation of the IT band. Running downhill is especially stressful on the IT band as it works to stabilise the knee.
Cyclists may develop ITB pain and inflammation if they exude improper posture on their bike and ‘toe in’ when they pedal. The problem may stem from how the toe clips are aligned thus forcing the foot to internally rotate. This can cause the same effect as bowed legs, increasing the angle of the IT band as it crosses the knee and increase the risk of inflammation.
Other activities with increased knee flexion can cause symptoms. These include rowing and weight lifting, where there is commonly excessive squatting.
ITB pain is a common presentation at our clinic. If you are suffering this condition, book online with one of our therapists today.