By Helene Mitchell, Physical Therapist Assistant
Iliotibial Band Friction Syndrome (ITBS) is the most common cause of lateral knee pain in runners and occurs in as many as 23% of the running population. It is more common in women than men.
Symptoms:
• Dull, achy, sharp, burning pain on the outside of the knee
• “Snapping” is heard or felt on the outside of the knee cap (patella)
• Does not always hurt at the start of a run but hurts after running a certain distance
• Symptoms are often worse after a run and it is more painful to run slow than fast
• Pain with squatting
• Pain after sitting for long periods
Causes:
• Excessive increase in running mileage or intensity
• Tight hip musculature
• Weak gluteal muscles
• Running on uneven surfaces or in same direction on a track
• Excessive downhill running
• Excessive foot supination
• “Bow legged”
Conservative Treatment:
Acute (less than 2 weeks):
• Ice massage
• Anti-inflammatory drugs
• Myofascial release
• Avoid downhill running or running in one direction on a track
• Stop running completely if pain begins immediately
Subacute (weeks 2 – 6)
• Gentle stretching
• Massage
• Foam roller exercises
• Hip strengthening
• Address footwear/orthotics
• Active rest and mild running every other day (if without pain)
Chronic: (6+ weeks)
• Hip strengthening
• Balance activities
• Return to running every other day then every day as symptoms subside
Complete cessation of symptoms takes 6 – 8 weeks. Gradually increase distance and frequency over a 4-6 week period. Faster running will cause less pain so start with strides initially.
