The iliotibial band syndrome is a common lateral knee injury which is related to the overuse of the connective tissues that are located on the outer thigh and the knee. It is usually felt with knee pain and tenderness on the palpation of the lateral part of the knee.
The iliotibial band runs along the lateral (outside) aspect of the thigh, from the pelvis to tibia crossing both the hip and the knee joint. This band acts as a stabilizing structure of the knee’s lateral part. It also helps with both- knee flexion and extension. Activities with repetitive flexion and extension of the knee can cause the iliotibial band to rub repeatedly along the lateral femoral epicondyles causing irritation and eventually an inflammatory reaction of the iliotibial band. Long-distance running and sudden increase in activity level can lead to iliotibial band syndrome.
In women, the risk factors include increased hip adduction and knee internal rotation while in men, increase hip internal rotation and knee adduction are major risk factors. Its also associated with weightlifting, exercises and military training. The prevalence of it in women is estimated to be between 16% – 50%, while for men it is between 50% – 81%. More chances are there of its appearance in adults as compared to the children.
The iliotibial band syndrome may be caused as a result of a combination of issues-
- Usually running consistently over a horizontally banked surface like the shoulder of a road or an indoor track on which the leg is bent slightly inward which causes extreme stretching of the band against the femur may result into an iliotibial band syndrome.
- Running downhill is especially stressful on the iliotibial band as it works at that time to stabilize the knee and avoid lateral knee injury. Bicyclists too may develop IT inflammation due to improper posture on their bike and “toe-in”. When they pedal it depends on the alignment of the toe clips, forcing the foot to be internally rotated. Other factors include inadequate warm-up or cool down, excessive running up and down the stairs, hiking long distances, rowing, spending a long time regularly sitting in the Lotus posture in Yoga, especially the beginners crossing the feet onto the top of the thighs.
- Exercises related to iliotibial band done without professional guidance can result in knee pain. Training errors too may cause runners to develop iliotibial band syndrome.
Certain traits too raise the chances of getting IB syndrome – like bowed legs, knee arthritis, one leg that’s longer than the other and weakness in the hip muscles.
The symptoms of a lateral knee injury typically begin a short time after the physical activity which is the cause of it, like exercises performed in the wrong way or long-running.
- Redness and warmth around the knee can be easily observed. Aching, burning or tenderness on the outside of the knee are the few major symptoms of this syndrome.
- The main symptom of iliotibial band syndrome is a sharp knee pain on the outer portion especially when the heel strikes the floor, that can radiate into the outer thigh or calf. The pain tends to worsen while running or moving downstairs due to internal lateral knee injury.
- Inaudible snapping sensation on the outer side of the knee can be felt due to the band’s flicking over the bony tubercle. The patient may experience on a regular basis an acute burning pain whenever pressure is there on the lateral femoral epicondyle with the knee inflation and in extension.
- Another symptom of lateral knee injury is inflammation due to the friction between the track and the lateral epicondyle.
If these symptoms are ignored the inflammation can continue with an increase in the knee pain and scarring will develop, decreasing the range of motion of the knee day by day.
Usually, a full physical examination of the lower back and legs, hips, knees and ankles is done to detect the causes of a lateral knee injury. X-rays are not usually required for its detection but MRI may be used to check the inflammation surrounding and beneath the iliotibial band. Most often it can be diagnosed without X rays and MRI images.
The iliotibial band syndrome is relatively easy to treat. Some of the most common ways to treat it include resting and avoiding activities that aggregate the iliotibial band, applying ice to the part with lateral band injury. The anti-inflammatory medicines those are easily available over the nearby medical counter, ultrasounds and ultra therapies to reduce the tension. There are special exercises that help both prevent and treat the conditions such as glute stretch, standing stretch and foam roller stretch. The most important treatment of it is stopping that
activity which causes the pain altogether and taking rest for minimum 6 weeks till the leg heals fully and the knee pain disappears.