ITB Syndrome

What is your Iiliotibial Band?

Your iliotibial band is a very strong band of connective tissue that starts from a few muscles in your hip that runs down and attaches to the outside of your knee. At your hip, the band attaches to your glute, part of your hip bone, but mainly comes from the tensor fasciae latae (TFL). This band basically serves as a tendon for these muscles, to allow them to function properly. It cannot be stressed enough that the IT band itself cannot be stretched due to the makeup of the tissue!

What is IT Band (ITB) Syndrome?

IT band syndrome arises when the muscles that the band attaches or the muscles under the band (lateral quad) become tight or irritated. This increase in tension of the muscles that pull on the band can cause the part that attaches to the knee to begin rubbing and become irritated. This irritation is usually felt as pain or tightness around the outside of the knee.

There are a lot of different structures in the body that can cause lateral knee pain and tightness. Being labeled as a “syndrome” there is no gold standard diagnostic test for this condition: We usually look for a collection of signs and symptoms. Here are some of the hallmark signs of this condition:

  • Pain, tightness, or tenderness on the outside of your knee
  • Develops over time and is not characterized by a sudden onset of sharp pain
  • Usually occurs in repetitive sports that involve running, jumping, etc
  • Symptoms may not begin until after warming up (1-2 miles into a run)

How Can We Help?

ITB syndrome is usually caused by caused by weakness of certain hip muscles surrounding your hip. This may seem counter intuitive, as tightness is usually thought to be associated with strong muscles. We have seen that muscle weakness often presents as tightness in many of our patients. One idea of why this might occurs when the muscle is weak or doesn’t have the endurance to keep up. Instead of contracting and relaxing normally, it contracts stronger and sustains the contraction instead of relaxing. This sustained contraction can lead to tightness “downstream” which is why symptoms are described in the outside of the knee, not the hip.

We will help by identifying the cause (ie which muscles may need some work). We will then progress you through a rehab program consisting of clinic based and home exercises to fix any deficits that we find. Treatment will generally consist of targeted manual therapy to help mobilize tight tissue and improve strength and endurance in the muscles that need it most.

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