Introduction

Iliotibial band (IT band) syndrome, also known as runner's knee, is one of the most common afflictions to the knee, whether or not you are a runner. The term runner's knee, known in the medical community as chondromalacia patellae, refers to a pain at the front of the knee.  Runner's knee is therefore a condition and not a diagnosis of the underlying problem.

The IT band is a tough and fibrous tendon that extends from the pelvis down along the outside of the thigh all the way to the upper shinbone. The purpose of the band is to provide stability for the knee, but it can become irritated because of friction between the IT band and the bottom of the femur. IT Band Syndrome is one of the most common causes of knee pain in runners and cyclists.

How it Happens

Repeatedly running on the same side of a sloped road can lead to friction, irritation, and inflammation of the IT band. This causes a tilt in the pelvis as one foot to strikes the surface below the other. This places extra stress on the IT band. There can be other causes of the condition including but not limited to: repetitive bending and straightening of the knee, anatomical irregularities like bowed legs and differences in leg length, excessive rolling of the foot and ankle, a lateral tilt to the pelvis, weak or tight gluteal muscles, and weak or tight quad muscles.

Conditions:

Tight IT band and connection to the tibia

IT band syndrome symptoms range from a stinging sensation just above the knee joint (on the outside of the knee or along the entire length of the iliotibial band) to swelling or thickening of the tissue at the point where the band moves to the femur.  Pain might persist after activity. Pain may also be present below the knee, where the IT band actually attaches to the tibia.

IT band connection to the hip

Runner's knee can  occur where the IT band connects to the hip, though this is less likely as a sports injury. It commonly occurs during pregnancy, as the connective tissues loosen and the woman gains weight, each process adding more pressure. Runner's knee and IT band syndrom at the hip also commonly affects the elderly.

Treatment

Initial Treatment

Biomechanical and Kinetic Chain Integrity are crucial components of addressing the IT Band.  Both the feet and the hips must be assessed for misalignment and fixations, either one may cause an increase friction on the IT band resulting in pain, adhesions, and dysfunction.  If the kinetic chain does not allow the flow of impact to travel from the foot into the spine, than it may at times show symptoms in the knee and IT band. 

Active Release Technique is a great tool for locating and treating adhesions of the IT band on the Quadracept muscles and knee capsule.  Shortening the structure, then putting a tension along the adhesion while elongating the IT band allows the adhesive fibers to free and normalize motion and function to that structure. 

Quantum Neurology Rehabilitation allows us to locate and rehabiliate the muscle imbalances of the leg, thigh, and hips.  Ensuring the adductor muscle, hip flexor, and pelvic stabilizer muscles are all firing properly is crucial in long term success of treating the IT band.

Orthotics: Ask your doctor about running with orthotics (shoe inserts) to change the position of the foot during physical activity.

• Take a break from the activity that causes the pain, but continue to train in activities that do not stress the IT band by swimming, walking, or cycling.
• Apply ice packs to the knee for 15-20 minutes, after activity
  
• On the advice of a chiropractor or physical therapist, stretch the IT band for 20-30 second periods, 4-6 times a day. (Stand next to a wall, place your right hand against the wall, cross your left leg in front of your right leg and gently push your hips toward the wall).
• Incorporate exercises from your chiropractor or physical therapist into your comeback routine/

See a chiropractor if symptoms do not subside within two weeks

Make an Appointment

By Phone

Call us at (858) 452-3734 and our helpful front office staff will be happy to assist you in making an appointment with Doctor Todd Plutchok, D.C.

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