WHAT CAN BLACKBERRY CLINIC DO TO HELP RUNNERS WITH ILIO TIBIAL BAND SYNDROME?
At Blackberry Clinic we have the expertise to offer accurate diagnosis using physical assessment and gait analysis. A programme of manual therapy, exercises and stretching from our physiotherapists, osteopaths or chiropractor, advice about training and running techniques plus PHITS orthotics if necessary would complete your road to recovery. For chronic ITBS our Musculoskeletal Medicine and Sport & Exercise Medicine doctors offer ultrasound guided steroid injections or dextrose prolotherapy injections.
To understand if this is what your pain is read the following information about ITBS.
THE INJURY
Iliotibial band syndrome (ITBS) has been compared to the feeling of somebody stabbing you in the side of the knee when you run,especially when going downhill. This annoying and painful injury can quickly become crippling if not addressed and corrected. The iliotibial band is a thick piece of connective tissue that runs parallel to your femur (thigh bone) from the outside of your hip to just below your knee.Pain is characteristically felt at the end of the IT band where it attaches to the outside edge of the knee.
THE SYMPTOMS
Pain is most frequently felt as a sharp point on the outside of the knee, or (rarely) as sharp pain on the lateral side of the hip. Commonly, pain occurs after a certain amount of running; not in the first few steps. While pain generally goes away after stopping activity, it often comes back when running is resumed. It’s most common in new runners, or after an increase in mileage or hill running.
THE CAUSE
The short answer is…lots of things. Most people mistakenly believe that ITBS occurs because of a tight IT band — but the IT band is supposed to be tight to do its job! The source of the problem is almost always weak hip and gluteus muscles. Weak gluteus muscles result in excessive side-shifting or movement of the pelvis which causes your femur (thigh bone) to move abnormally; the outcome being unusual loading of the supportive IT band, ‘pulling’ it away from your knee. Running downhill and always running on the same side of the road are common culprits. Running on the same side of the road close to the pavement can be problem because of the camber of the road which means your pelvis is tilted as one leg is always ‘longer’ angled down into the gutter. This also applies to track/field running where your inside leg takes shorterstrides than your outside leg – again you should run around in both directions to ‘even’ things out and prevent injury.Running at angles puts a lot of stress on the side of the knee and can cause friction between the IT band and the femur. Over-pronation and a leg-length discrepancy can also be contributing factors.
Many runners find that as fatigue sets in, their ankles or knees collapse inwards, which in turn pulls on the IT band, forcing it to rub against that bony spot on your knee. This re-enforces the importance of having strong legs to prevent injury. This can be achieved through specific strengthening exercises.
THE FIX
ITBS can be challenging to treat, but gluteus muscle and hip strengthening are immensely important in both the prevention and treatment
processes. A regimen of icing and anti-inflammatories will assist in reducing pain. A foam roller can be used to loosen up tight structures as can massage. Physical therapy treatments will work on releasing structures that are shortened and tight – movement-based treatment for soft tissue injuries will help to break
up scar tissue and restore normal function. Strengthening exercises for hip abductors, core and gluteus muscles will be prescribed by your physical therapist along with a stretching programme. Avoid aggressive downhill running, ease off on the volume and intensity of training(or take a complete rest if that is advised and cross train to keep fit).
THE PREVENTION
Maintaining good soft tissue mobility is essential. Regular stretching and massage as well as foam rolling can help prevent the development of ITBS. Strengthening the gluteus muscles and hip, including your core will provide a more stable pelvis and reduce the ‘tugging’ on your ITB. A little ‘prehab’ goes a long way to preventing most running injuries, and is less
costly and time-consuming to practice healthy than when injured. Always look at your training programme and monitor volume and intensity, as well as excessive downhill routes, too much
too soon will cause ITBS. Remember tips like running on different sides of the road and switching directions if running the same routes frequently or round
a track. Have your form assessed for excessive pronation and get advice about orthotics, as they may help prevent an injury. Vary running surfaces as well. Mix hilly runs with
flat routes. Try trails and soft surfaces to ease the pounding placed on legs by only running on roads.
The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case. (Blackberry Clinic Group Ltd 2020)
