1. What is it?
The iliotibial band (ITB) is a sheet of fibrous tissue that extends from the outside of the hip, down the outer thigh to the outside of the knee. The ITB helps to stabilize the knee joint. During normal movement, as the knee bends and straightens, the ITB rubs over part of the femur. If the rubbing is excessive, injury occurs.
2. What are the causes/predisposing factors of injury?
Intrinsic factors leading to injury may include: misalignment of the feet, knees, pelvis or hips, leg length differences, high arches and bowed legs. Other contributing factors can include: worn out shoes, running on crowned roads, excessive increases in mileage and or speedwork.
3. What are the symptoms?
Sharp pain that is felt on the outside portion of the knee that may radiate up the outside of the thigh is the usual presentation. Movements such as going up and down stairs, squatting or sitting with the leg crossed may aggravate the condition. This problem can be very persistent and last many months or longer.
4. What can be done to prevent or treat this condition?
Prevention focuses on reducing the predisposing factors mentioned above. For example: overpronators should consider motion control shoes, those with excessively high arches should be in cushioned shoes. A program that enhances the strength and flexibility of the hip abductor muscles (gluteus medius and tensor fascia latae muscles) is also recommended.
Treatment of ITBS is multi-faceted. Reducing training intensity and volume, running on flat terrain and avoiding downhill running may all help. Doing non-impact cardio if the symptoms are severe is another good alternative.
Physical therapeutics, NSAIDS (non-steroidal anti-inflammatory drugs), soft tissue therapy, joint manipulation and rehabilitation exercise all play a role in treating ITBS. In severe cases however, surgery may be required to release the ITB if conservative means are unsuccessful.
A worse case scenario may see chronic ITBS leading to a knee problem by causing improper patellar alignment. What can result is a deterioration of the cartilage on the underside of the kneecap along with the pre existing ITBS.
(Update: Take a look at this video from Fitsugar.com about how to use a foam roller on your IT band.)