Knee Pain, Knee Injuries and Iliotibial Band Syndrome

Knee pain and knee injuries, as a result of Iliotibial Band Syndrome, can be an extremely painful and frustrating injury that puts a big strain on both the knee and hip joints.

Knee pain and knee injuries are very common among runners and cyclists. However, they don't usually occur in an instant, like a hamstring strain or groin pull, but commonly start off as a twinge or niggle, and progress quickly to a debilitating sports injury that can sideline the best of us for weeks.

For those who aren't familiar with Iliotibial Band Syndrome, let's start by having a look at the muscle responsible for the problem. The iliotibial band is actually a thick tendon-like portion of another muscle called the tensor fasciae latae. This band passes down the outside of the thigh and inserts just below the knee.

If you look at the anterior (front) view of the right thigh muscles and follow the tendon of this muscle down, you'll see that it runs all the way to the knee. This thick band of tendon is the iliotibial band. Or iliotibial tract, as it is labelled in the diagram.

The knee pain occurs when the tensor fasciae latae muscle and iliotibial band become tight. This causes the tendon to pull the knee joint out of alignment and rub against the outside of the knee, which results in inflammation and pain.

CausesThere are two main causes of knee pain associated with iliotibial band syndrome. The first is "overload" and the second is "biomechanical errors."

Overload is common with sports that require a lot of running or weight bearing activity. This is why ITB is commonly a runner's injury. When the tensor fasciae latae muscle and iliotibial band become fatigued and overloaded, they lose their ability to adequately stabilize the entire leg. This in-turn places stress on the knee joint, which results in pain and damage to the structures that make up the knee joint.

Overload on the ITB can be caused by a number of things. They include: 

• Exercising on hard surfaces, like concrete;
• Exercising on uneven ground;
• Beginning an exercise program after a long lay-off period;
• Increasing exercise intensity or duration too quickly;
• Exercising in worn out or ill fitting shoes; and
• Excessive uphill or downhill running.  

Biomechanical errors include: 

• Leg length differences;
• Tight, stiff muscles in the leg;
• Muscle imbalances;
• Foot structure problems such as flat feet; and
• Gait, or running style problems such as pronation.  

Treatment For Iliotibial Band Syndrome

Firstly, be sure to remove the cause of the problem. Whether is be an overload problem, or a biomechanical problem, make sure steps are taken to remove the cause.

The basic treatment for knee pain that results from ITB Syndrome is no different to most other soft tissue injuries. Immediately following the onset of any knee pain, the R.I.C.E.R. regime should be applied. This involves Rest, Ice, Compression, Elevation, and Referral to an appropriate professional for an accurate diagnosis. It is critical that the R.I.C.E.R. regime be implemented for at least the first 48 to 72 hours. Doing this will give you the best possible chance of a complete and full recovery.

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