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ITB strain

Causes and Management of Iliotibial Band (ITB) Syndrome

The iliotibial band is a thick band of fascia that runs down the outer surface of the thigh. ITB syndrome is a repetitive strain injury often presenting with symptoms of pain or tenderness on palpation over the outer aspect of the thigh and knee. Eventually the pain will be so severe causing pain on every step and challenging climbing up and down the stairs. This condition is mostly seen in cyclists and runners.


Here are some common cause and management of the condition:


Often most, the cause of ITB Syndrome is due to overuse. This could be a result of overtraining for an upcoming competition, or pushing too hard too fast on the muscles. Therefore, consistent pacing and sticking to a training schedule is important to avoid overstraining the muscles and other soft tissues.
So, what can be done?
If the condition is not severe, icing and resting usually does the trick. Besides that, try taking a break from running or cycling for a few days to allow the ITB and its associated muscles to heal. Then, gradually return to activity and progress slowly. Other alternatives include modifying the usual training regime like changing to a different running course.

Tight or weak hip muscles

Muscle weakness of the hip abductors (gluteus medius) has been found as one of the major causes of ITB syndrome. Muscle weakness of the hip abductors leads to an increase of hip internal rotation and knee adduction. This position puts a lot of stress on the knee joint, Other muscles, including the ITB, has to work harder to compensate.

Therefore, consistent stretching of the ITB and strengthening of the hip abductors is essential in the recovery process and prevention for future relapse. Some useful exercises for strengthening the hip abductors include: leg raises on side lying, clamshells, single-leg hip thrusts and banded lateral walks.

Running form

Running with a bad form puts a lot of stress onto the knee and the related structures surrounding it. Bad running form like, running with the knees and hip collapsing inwards or over striding (exaggerated big steps) reduces efficiency and increases the risk of injury. Taking videos of your running gait and analyzing it, could help you pick up bad running forms which are more subtle. Or, seek professional advice from a physiotherapist to find the right and receive suggestions on how to correct and improve it.

Footwear and orthotics

Running with a pair of good and comfortable shoes is important, to prevent the foot from landing in an awkward position. A pair of old and worn out shoes with poor support, is unable to absorb the shock when running. All of the impact will be transferred to the knee and hip, contributing to the strain on the ITB. Besides that, runners with arch problems or any leg length discrepancy should also consider customized insoles for better arch support.