Iliotibial band syndrome

Iliotibial band syndrome is a thigh injury particularly common to runners, cyclists and certain types of weight-lifter. It causes instability of the knee during movement, resulting in intense knee pain while exercising.

Symptoms

Stinging pain above the outer side of the knee joint, and sometimes below the knee. Inflammation of the iliotibial tissue where the band chafes across the femoral condyle. There may be no immediate pain when you begin exercising but it will intensify as the routine progresses and may continue when you have finished training. You will almost certainly experience diminished balance on the injured leg.

Causes

The iliotibial band is a thick section of the tensor fasciae latae muscle extending down the thigh and meeting the knee. If it tightens then this can wrench the knee joint out of alignment causing inflammation and pain. A frequent cause of this tightening is weakness of the hip abductor muscles, as this overburdens the iliotibial band by greatly increasing the pressure placed upon it.

You should look for activities that have been placing an inordinate strain on the band, often due to a running or weight-training routine with an overuse of steep hills, hard or uneven ground. This can lead to asymmetrical muscle strength. Other imperfect training practices can also contribute to the condition, such as starting a demanding routine of sport or exercise immediately following a period of inactivity, or otherwise expanding your training too rapidly. Using worn out or inappropriate shoes is another risk factor.

Structural errors in your feet and legs may also set off the injury. Uneven leg length, bowlegs, or irregular foot arches can all lead to this sort of inflammation over time, as can overpronation in the foot so that the arch is abnormally flattened and the heel curved inwards.

Treatment

Avoid cycling, running and weight-lifting (especially squats and deadlifting) while injured. Contact sports like martial arts and wrestling should also be avoided, and court sports like basketball and tennis which involve high impact on your knee joints.

Rest the joint and ice it generously, using massage therapy if available. Stretch your side muscles and strengthen hip abductors suitably. A common method of undertaking the latter is to balance on one leg and then, keeping that leg straight, to gently tilt the hip upwards. To combat overpronation, a change in footwear will be beneficial.

Seeking Medical Advice

Your doctor will perform a physical examination to diagnose the injury, and might recommend that you see a physiotherapist or a chiropractor if the symptoms do not improve after 2 to 3 weeks of taking the above steps. They can also prescribe anti-inflammatory medication if necessary.

Prevention

Effective and appropriate stretching is one of the keys to preventing further injury of this sort, and results in an altogether improved and safer training program. Replace worn or faulty shoes with a kind catered to your type of foot, and consider using inexpensive, easy to find orthotic inserts to amend biomechanical problems of the foot like supination or pronation. Also pay careful attention to your training practices, varying how you exercise and limiting the amount of time spent on uneven surfaces and hills.