Iliotibial Band Syndrome

Author: Wing Kwok | Sports Therapist | Fascia & Pilates

Iliotibial band syndrome (ITBS) is a common running-related injury that also affects other active individuals, especially those who frequently bend and extend their knees, such as long-distance runners and cyclists. Those who experience a sudden increase in training volume are particularly prone to pain and inflammation caused by excessive friction of the iliotibial band. The iliotibial (IT) band is a thick fibrous band that runs from the hip to the outside of the knee, helping to stabilize and move the hip and knee joints.

The causes of iliotibial band syndrome are usually related to the following factors:
1. Overuse:
Long-distance running, frequent cycling, or other repetitive leg movements can lead to overstretching or friction of the IT band, causing inflammation.
2. Biomechanical Issues:
Improper alignment of the hips, knees, or feet, such as pronation, supination, or flat feet, can lead to abnormal stress on the IT band.
3. Muscle Imbalance:
If the inner thigh muscles (e.g., vastus medialis) are weaker compared to the outer muscles (e.g., gluteal muscles and vastus lateralis), it can cause abnormal tension in the IT band.
4. Training Errors:
Running on hard surfaces, wearing inappropriate running shoes, not warming up sufficiently, or neglecting stretching can all increase the risk of developing IT band syndrome.
5. Sudden Increase in Training Intensity:
Rapidly increasing running mileage, speed, or intensity without giving the body enough time to adapt can lead to IT band injury.
6. Running Form:
Improper running posture, such as excessive foot crossover or body lean, can also increase stress on the IT band.
7. Terrain Factors:
Long periods of running on sloped or uneven surfaces, especially always on one side of the road, can lead to overuse of the IT band on that side.
8. Sitting Posture:
Prolonged sitting, especially with crossed legs, can lead to tightness and shortening of the IT band.

Treatment for IT Band Syndrome typically involves rest, physical therapy, massage of the tensor fasciae latae and gluteus maximus, and specific stretching and strengthening exercises. In some cases, custom orthotics may be needed to alter lower limb mechanics or adjust the training plan.

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