How To: Solve ITB Pain
Emily asks: I’m having some pain on the outside of my knee. It seems to kick in at about kilometre six and gets worse if I continue running. I’ve taken a few days off and it seems to be no better. Any idea what this might be and what to do?
Based on your description, it sounds like you may be experiencing Iliotibial Band Syndrome, or ITBS. When pain is an issue for several days and does not get better with RICE – rest, ice, compression, and elevation – it’s time to see the doctor.
ITBS is an inflammation of this large band of connective tissue that runs the length of the thigh. It begins on the outside of the hip and continues down to the shin. The main function is to stabilise the knee, assist with inward rotation and help with hip abduction.
It’s a very common injury that may be more prevalent in female runners than males. It is thought that women may be more susceptible to this injury because they tend to have a wider pelvis than men, and a wider pelvis means a greater degree of rotation when running – meaning more stress is placed on the IT band.
Your doctor may order an MRI to confirm a diagnosis and may also prescribe an anti-inflammatory and/or physiotherapy. Physiotherapy can assist with treating the symptoms, as well as addressing the source of the problem.
Often, weak gluteal muscles and over-tight hip flexor muscles from sitting all day at work contribute to this injury. Physical therapy addresses any muscle imbalances and prescribes the appropriate exercises for improving both flexibility and strength. Your doctor or physio may also evaluate you for orthotics, a custom-made shoe insert, that helps correct biomechanical deficiencies.
Here are some tips for when you can return to running:
- Do a good warmup before running. Walk first, then gradually move into an easy jog.
- Obtain a professional shoe fitting. A motion-control or a stability shoe may help.
- Check your shoes for wear and tear and replace them often.
- Run on level surfaces and avoid cambered roads. The slant of the road can contribute to this IT band injury.
- Avoid running on concrete or other exceptionally hard surfaces.
- If running on a track, change direction and run in the outer lanes for a wider turn.
- When increasing mileage, stick to increasing weekly mileage by no more than 10 per cent a week.
- Cross-train with activities like swimming, if possible.
- Try using a knee strap to immobilise the IT band at the knee.
- Continue doing prescribed strengthening and stretching exercises.
One of the most effective strengthening exercises for ITBS prevention is the “clam shell.” Here’s how to do it.
- Lie on the floor on your side, legs stacked. Bend both knees, keeping legs and feet aligned. Open the knees like a clam shell while keeping your feet together. Do 2 sets of 30 on each side. Take it to the next level by put a resistance band around your thighs.