The Anatomy
The Iliotibial Band is a dense, fibrous band that runs along the outside of the thigh. Only the proximal portion located up by the hip is muscular. The muscular portion is referred to as the tensor fascia latae and it originates from the area of the anterior superior iliac spine, which is the bony prominence at the front of the hip region. The tissue then becomes fibrous and runs down the center of the outside of the thigh. From there, it inserts into the distal femur, or thigh bone, and gerdy’s tubercle, which is located on the outside of the lower leg bone. The IT band does have extensive fascial connections with the vastus lateralis, or lateral quad. In addition, the IT band also covers the fibula, which is the outside bone of the lower leg, and can actually restrict the motion of the fibula.
What Will You Experience?
The symptoms of IT band syndrome will classically start with diffuse pain over the outside of the knee. Then, the pain will progress into a sharp sensation that becomes more localized along the outside of the knee. The symptoms will typically start right after a long distance run or bike ride. As symptoms become more intense, the pain will become more prominent sooner during the activity. Patients typically report more aggravation and pain when running downhill, when they lengthen their stride, or when they are sitting for long periods of time with the knee in a bent position.
What is It?
Iliotibial Band Syndrome is an inflammation and irritation of the insertion of the IT band along the lateral femoral condyle. This condition typically occurs with excessive flexion and extension of the knee. When the knee is in the extended position, or straight, the insertion of the band is in front of the lateral femoral condyle. When the knee is flexed 30 degrees or more, the tissue is in the back of the lateral femoral condyle. Therefore, when a person is excessively moving the knee from flexion to extension, such as in long distance running and biking, the tissue at the insertion of the band repeatedly rubs against the bony prominence of the condyle. This repeated rubbing is what causes the inflammation to occur within the tissue. The continued inflammation causes a thickening of the tissue, which perpetuates the condition by making the tissue even tighter.
Predisposing Factors
There are a few biomechanical issues that can lead to this syndrome. One such issue is overpronation of the foot, also known as flat feet. This specific biomechanical issue actually leads to other problems up the kinetic chain, which will end with excessive stress being placed on the IT band. Another very common problem found among those with IT band syndrome is inflexibility in the IT band. When the IT band becomes tight, it is unable to transfer force correctly and will lead to more strain being transmitted to the insertion point, where the pain is usually located. A couple of the muscle groups that are found to be weak with this condition are the glute medius and the adductors. When these muscle groups become weak, their supporting function is compromised. This in turn leads to more stress being put on the IT band. Sources show that IT band syndrome is found equally among men and women, although women may be more susceptible due to the presence of an increased inward angle from the hips to the knees. The population that commonly experiences this condition are distance runners, due to the fact that their foot spends more time in stance phase, or in the flat position.
What Will Lake Marion Chiropractic Do for You?
At Lake Marion Chiropractic, we approach each condition with a personalized plan. Your evaluation will involve some functional movement tests, which will help us determine where there is tightness and where there is weakness. By seeing how the body moves, we are better able to break down where compensations may be occurring so that we can fully address the cause of your syndrome. With IT band syndrome, the first thing that we will address is the inflammation, usually with ice and some nutritional consultation. As the inflammation and pain subsides, treatment will be shifted towards soft tissue techniques that will address tissue tightness. These techniques include the Graston Technique, massage, and myofascial release. The patient will also be shown stretches that can be performed at home. To make sure that the condition is completely resolved, the patient will also be given corrective exercises that address any weaknesses in the kinetic chain. This approach is tailored to the specific patient and it is designed to help prevent the condition from occurring again.