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Iliotibial band syndrome (ITBS) is a painful condition of the iliotibial (IT) band. Endurance trainers such as long-distance runners and cyclists are at higher risk, but ITBS can affect anyone. Poor training practice ( e.g. improper form, no warm-up, or going “HAM”) also puts people at greater risk for ITBS and other sports injuries.
The Iliotibial (IT) Band
The IT band is a long band of fascia that runs along the outer surface of thigh muscles from the hip area to below the knee. It is involved in leg flexion, abduction, lateral rotation as well as hip abduction. The IT band provides stability to the hip and knee joints during movement.
The IT band may play a role in energy recycling during walking and running. Research from an evolutionary standpoint suggests that the elastic properties of the IT band allow it to store and release energy (“like a spring”) to support locomotion (2).
Iliotibial Band Syndrome
ITBS results from injury to the IT band from acute trauma, overuse, and altered joint mechanics. There are several theories to explain the origin of ITBS. Two of the most common involve irritation by friction between the IT band and the epicondyle of the leg bone and repeated compression of connective tissues under the ITB (3). Instability of the knee joint itself could also be a factor. Abnormal running, dysfunctional joints, or injured ligaments can lead to a compensatory tightening of the IT band and subsequent irritation. ITBS could also be a result of a combination of any of these factors.
Treatment for ITBS includes rest, therapeutic exercise, stretching, and massage (3). These are generally effective at treating pain and restoring the function of the IT band. Manipulative treatments such as chiropractic and osteopathic can help restore structural alignment and remove mechanical restrictions that may be interfering with the healing process. These can also help restore muscle balance and work to improve gait and posture.
When ITBS is persistent and conservative treatments fail to work, pain medication like corticosteroid injections and non-steroidal anti-inflammatory drugs (NSAIDs) may be considered. Anti-inflammatories, however, may interfere with the healing of soft tissues of the knee and delay the process. If all treatments seem to fail then surgical intervention may be considered.
Prolotherapy is an injection-based regenerative treatment that aims to repair injured soft tissues- alleviating pain and restoring function. In the case of ITBS, prolotherapy can be administered to strengthen and tighten soft tissues of the knee joint that may be injured and contribute to altered joint mechanics. Unlike corticosteroids and NSAIDs, prolotherapy induces inflammation at a specific spot to promote healing by recruiting healing mechanisms to the areas.
- Beals, C., & Flanigan, D. (2013). A Review of Treatments for Iliotibial Band Syndrome in the Athletic Population. Journal of Sports Medicine, 2013, 1-6. doi:10.1155/2013/367169
- Reuell, P. (2015, August 26). Understanding the IT band. Retrieved from https://news.harvard.edu/gazette/story/2015/08/understanding-the-it-band/
- Lavine, R. (2010, July 20). Iliotibial band friction syndrome. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941581/