Iliotibial Band Friction Syndrome (ITBFS)

Iliotibial Band Friction Syndrome (ITBFS)

As I continue along the blogging trend of common running injuries, Iliotibial Band Friction Syndrome (ITBFS) is the next one that comes to mind. Many of you may have heard of your “IT Band” before, however, may not exactly know what it is or what implications it may have on you.

What is your Iliotibial (IT) Band?

To put it simply, your IT Band is a thick band of connective tissue that extends from the outside of the hip/pelvis down to the outer region of the knee. The IT Band serves as an attachment site to proximal muscles around the hip such as your tensor fascia latae (TFL) and gluteus maximus. Distally, it helps to serve as a lateral stabilizer to the knee while weight-bearing.

What is IT Band Friction Syndrome (ITBFS)?

ITBFS is a condition often seen in runners and is characterized by pain around the lateral aspect of the knee. As your knee flexes and extends, the distal part of the IT Band rubs over the lateral femoral epicondyle (a bony prominence) of the femur (thigh bone). It is this site of repetitive rubbing/friction, which can eventually lead to ITBFS. Individuals usually report that their pain appears insidiously over time, without any memorable injury. It is also common for individuals to report that the pain appears at a fairly consistent distance or time into the specific aggravating activity, such as running. Their symptoms may progress from a dull/stiff sensation to a more sharp/stabbing pain as the condition worsens.

What Causes ITBFS?

As mentioned above, ITBFS symptoms usually appear gradually overtime, and therefore falls under the category of “overuse injuries”. An in-depth physical assessment is necessary, in order to determine the specific causal factors which have predisposed one from getting ITBFS. A few of the common dysfunctions we see in our clinic are listed below:

  • Errors in training
    • A drastic increase in training frequency, distance or speed
    • Running on a cambered surface
  • Muscular weakness
    • Core
    • Gluteus medius & other lateral hip stabilizers
    • Deep external rotators of the hip
  • Poor biomechanical awareness & control
  • Soft tissue tightness/inflexibility
    • TFL
    • Quadriceps
    • IT Band
  • Leg length discrepancy
  • Over-pronation of the foot
  • Inappropriate footwear

What is the treatment for ITBFS?

ITBFS is treated conservatively with the underlying causal factors are determined. Some common treatment techniques include:

  • Modalities for the acute management of pain and inflammation
    • Ice
    • Anti-inflammatory medication
  • Correcting errors in training
    • Activity modification
    • Cross Training
  • Addressing soft tissue dysfunctions
    • Strengthen weak musculature
    • Stretch & release tight tissue
  • Improve biomechanical awareness & control
  • Footwear & orthotic assessment/correction
  • Bracing & taping techniques

Please consult with your health care provider if you wish to discuss your ITBFS symptoms further. If you have any questions specific to this article please contact:

Teresa Agar, MScPT, BHKin
Registered Physiotherapist

Trailside Physio – Coquitlam Clinic

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