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Diagnose and Treat Iliotibial Band Syndrome

ITB Running Injuries Can be Merely Irritating or a Show-Stopper

Location of the illiotibial band; photo courtesy Beth Ohara

As runners, despite our best efforts, at one point or another a sports injury will rear its ugly head. And sadly, most of us are recreational athletes, and don’t have access to routine attention by sports medical folks like massage therapists, sports physiologists, holistic medicine practitioners, and rolfing specialists.

The result is that to avoid issues such as ITB, plantar fasciitis, or achilles tendon tears, we must educate ourselves. An ounce of prevention is worth a pound of cure.

We must recognize that basic injuries are commonly related to overuse or a mechanical imbalance. This is not to say that we should avoid consulting a doctor. The good thing is that some of these injuries are so common that recognizing them is fairly obvious.

What and Where is My Iliotibial Band?

The ITB runs down the outside of your leg (see the picture above). It attaches to the top side of your hip area via your gluteal muscles and at your tensor fascia lata muscle. It also attaches to the bottom of your tibia, just below your knee. As far as your running is concerned, the key functionality is stability. In this regard it does an extraordinary job, as long as you remain healthy.

But once it becomes inflamed, your trouble begins. You will usually notice either a pain on the outside of your knee or on the outside of your thigh, or both. When this occurs, your diagnosis is iliotibial band syndrome (ITBS). This can take you out of the game if you don’t receive treatment.

What are the Causes of ITBS?

It’s usually caused by one of two things, either overuse or your individual biomechanics. Overuse might come from consistently running on the same side of a roadway that’s cambered to allow for water to run off. This will create an imbalance. The ITB on one side ends up longer and on the other side shorter.

The way to prevent it in this situation is to run on a flat surface or on one that angles back and forth enough to even out, such as trails.

Overuse also comes from adding in too many miles too quickly in your training program. Running on trails or walkways (crushed gravel, dirt, or asphalt) is preferable to concrete sidewalks because of the firmness of the surface.

In Houston, running venues like Memorial Park are ideal. But south of Houston, in the Webster/Clear Lake area, check out the Seabrook Trails or the Red Bluff hike ’n bike trail (along Red Bluff from Bay Area Blvd. towards Pasadena).

For biomechanical issues, it can be aggravated by having bowed-legs, differences in your leg length, and over-pronating. The pronation problem is why it is so critical to be fitted with correct running shoes. Injuries that would never present themselves during normal everyday activity are brought to the forefront when pounding out the miles.

How to Avoid this Condition

As stated above, don’t run at a consistent angle.
Stretch regularly, at least on a daily basis. Specifically, do stretches that involve the legs. There are many yoga poses that will help you here.
Use an ITB band such as the Pro-Tec Athletics Iliotibial Band Compression Wrap. For prevention, just use it on your long runs; using it too much will actually weaken you. If you are already injured, stick with very short maintenance runs and use it then.
At the slightest hint of an injury, apply ice frequently.

How Iliotibial Band Syndrome is Treated

I must state that this is not a professional medical opinion, since I’m not legally qualified, these are just methods commonly accepted in the running community. Obviously, the first thing to do is back off on your weekly mileage until your injury is under control. I know that a lot of runners use ibuprofen to control their pain.

This is not recommended when doing endurance activities (use aspirin instead), but runners shouldn’t be doing long distance running with ITBS anyway. Stretching is also recommended. There are specific stretches to isolate the ITB.

Ideally, you should try to avoid this injury before it has a chance to manifest. Buy and wear correct running shoes. Do your running on surfaces that are not predominately angled in one direction. Train on softer, more forgiving surfaces. Keep up with a stretching program. And finally, have fun.

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