Don's Home Health Sports Injuries Hip and Leg Injuries Iliotibial Band Syndrome
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    IT Band Syndrome or ITB Syndrome OR ITBS

    Causes | Prevention | Exercise | MyoFascial Release Therapy (MFR)


    ITBS is an overuse injury of the tissues located on the outer part of thigh and knee. It causes pain and tenderness in those areas, especially just above the knee joint.

    Iliotibial band syndrome is a common knee injury that usually presents as lateral knee pain caused by inflammation of the distal portion of the iliotibial band; occasionally, however, the iliotibial band becomes inflamed at its proximal origin and causes referred hip pain. The iliotibial band is a thick band of fascia that is formed proximally by the confluence of fascia from hip flexors, extensors, and abductors. The band originates at the lateral iliac crest and extends distally to the patella, tibia, and biceps femoris tendon.


    • Overuse
    • Poor Running Form
    • Consistently running on a banked surface, which causes the downhill leg to bend slightly inward, causing extreme stretching of the band against the femur (such as the shoulder of a road or an indoor track)
    • Positioning the feet "toed-in" to an excessive angle when cycling
    • Inadequate warm-up or cool-down
    • Wearing worn-out shoes
    • Tight Tissues
    • Weak Hip Muscles
    • Shoe or Orthotic Issues
    • High or low arches
    • Supination or over-pronation


    • Most importantly, always decrease your mileage or take a few days off if you feel pain on the outside of your knee.
    • Walk a quarter to half-mile before you start your runs.
    • Make sure your shoes aren't worn along the outside of the sole. If they are, replace them.
    • Run in the middle of the road where it's flat. (To do this safely, you'll need to find roads with little or no traffic and excellent visibility.)
    • Don't run on concrete surfaces.
    • When running on a track, change directions repeatedly.
    • Schedule an evaluation by a podiatrist to see if you need orthotics.
    • Wear compression shorts/tights. Dill's post at ITBS nightmare - Health + Injury - Runner's World says,
      "I nearly gave up running a couple of years ago due to ITBS. I tried everything rollers, exercises, tennis balls, acupuncture, massage, physio and just about everything else.

      There is little doubt that ITBS stems from problems with the hip and glutes. (In my untrained opinion anyway). Having spent an evening researching the condition again i read an article stating the benefits of wearing compression shorts/tights for ITBS. I bought a pair and wore them for all my runs and within two weeks my pain stopped. In the last two years i have had it once and that was during a 50 mile race where i had decided to wear a cheapo pair of compression shorts to save a few quid instead of my usual Skins. I don't know how or why this worked for me but it did and i wear them all the time now."

    In 3 Ways to Conquer IT Band Pain | they recommend foam rolling.
    At Issues with foam rolling | they discuss it.
    It is a self administered Myofascial release therapy; see below

    There are several kinds of stretches which will help.
    The yoga pigeon pose will help.
    See Summit Medical Group - Iliotibial Band Syndrome Exercises

    RICE - Rest, Ice (15 min. several times a day), Compression, and Elevation
    Treatment requires activity modification, massage, and stretching and strengthening of the affected limb. The goal is to minimize the friction of the iliotibial band as it slides over the femoral condyle. The patient may be referred to a physical therapist who is trained in treating iliotibial band syndrome. Most runners with low mileage respond to a regimen of anti-inflammatory medicines and stretching; however, competitive or high-mileage runners may need a more comprehensive treatment program.

    MyoFascial Release Therapy (MFR):
    Myo - Muscle
    Fascia - which comprises the fascial web - is like a thin film of fibrous connective tissue separating or binding together muscles, organs and even bones. This tissue covers every muscle and every fiber within each muscle. Fascia binds some structures together, while permitting others to slide smoothly over each other.
    Under a microscope Myofascia resembles a spider web or fish net.
    A combination of dehydration and the elements of life such as the repetitive movement causes fascia and muscle to bind together, which inhibits the muscle's ability to move efficiently. Pressure needs to be applied to these adhesions, or trigger points, to help break it up and release it, which is what myofascial release is all about.
    At the Grace Myofascial Physical Therapy Clinic
    they say,
    "Myofascial Release Physical Therapy is a manual form of Physical Therapy which helps rebalance the soft tissue throughout the body, thereby, allowing relief and often complete resolution of pain."

    It is a treatment for a variety of resulting conditions such as chronic back pain, carpal tunnel syndrome, plantar fasciitis, Temporo-Mandibular Joint disorder (TMJ), and vertigo.

    Some people use products like foam rollers (see above) every day. BuiltLean they say, "almost every serious endurance athlete and most professional athletes incorporate myofascial release into their exercise routines."

    Self-myofascial release? | MELT Method is another self-administered system similar to MFR.
    Balance Orlando Massage and Structural Therapy - Myofascial Release
    Myofascial Release: Definition, Trigger Points, & Therapy (TPT) - BuiltLean
    What is Myofascial Release Physical Therapy? - Grace Myofascial Physical Therapy Clinic - Jackson, MS
    Self-Myofascial Release Techniques and products |

    Myofascial Release Therapy: A Visual Guide to Clinical Applications: Michael J. Shea Ph. D., Holly Pinto | Books

    Iliotibial band syndrome - Wikipedia, the free encyclopedia
    Iliotibial Band Syndrome: A Common Source of Knee Pain - American Family Physician
    Summit Medical Group - Iliotibial Band Syndrome Exercises
    3 Ways to Conquer IT Band Pain |
    Iliotibial Band Syndrome | Runner's World & Running Times
    Issues with foam rolling |

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last updated 10 Apr 2014