ITB Syndrome

ITB Syndrome is a common repetitive injury that can affect athletes such long distance runners, footballers, netballers, tennis players, basketballers and anyone who runs or works out on hard surfaces. It presents as lateral knee pain (pain on the outside of the knee) and can start off as just a niggle but has potential to become a serious problem. Early intervention of this injury is extremely beneficial in making sure it doesn’t progress into something that keeps you away from your sport! The ITB itself is a long thin band of fascia that attaches at the top of your thigh and is controlled by your Tensor Fascia Latae (TFL) and Gluteus Maximus and runs down the outside of your leg, attaching to the Tibia and Femur at the knee joint.​ These muscles keep the knee aligned and help to control unwanted movement.

Presentation and possible causes

​Simply put, ITB Syndrome is basically when the ITB rubs over the bones of the outer knee, causing pain, inflammation and often swelling.​ Being an injury of repetitive nature means that ITB Syndrome is a chronic injury, gradually building up over time rather than coming on due to one specific incident. There are several possible causes which can include poor biomechanics when running, weak hips and glutes, unsuitable footwear and/or sudden increases in training load/running distance.​

Self-Treatment Exercises

These are some exercises that you can do to help alleviate the symptoms of ITB Syndrome. You can also use these exercises as a proactive measure to prevent ITB tightness if you do a lot of long distance running, run on hard surfaces, or are looking to increase your workload. Bear in mind these will only treat the symptom and it would be wise to seek professional advice in order to address the underlying cause of the problem.

SPIKEY BALL THROUGH GLUTES AND PIRIFORMIS

● Roll through with foam roller first if you need to

● With spikey ball roll across attachments at iliac crest working across the fibres

● Work down the muscle towards hip joint, pausing on the tighter/knotty areas until they feel looser (will most likely be painful and sometimes refer pain down leg or towards the middle of the glutes).

● Put leg in figure four position as shown, roll spikey ball across the muscle starting at the sacrum and working out towards the hip joint, pausing on tighter areas.

SPIKEY BALL THROUGH TFL

• On your side and facing slightly downward, position the ball at the top of the iliac crest (hip bone) just behind the ASIS
• Roll transversely across the muscle working downwards towards the hip joint, pausing on tight areas.

FOAM ROLL ITB AND QUADS

● Position foam roller at the top of the ITB just under the lateral area of the hip joint. Roll length ways up and down the ITB/Lateral quads, pausing on tighter areas.

COUCH STRETCH FOR HIP FLEXORS

• Position knee into the couch as shown with the other foot on the floor infront.
• Keeping your core braced, without arching the lower back slowly raise your body back towards the back of the couch until a stretch is felt in the hip flexor and hold for 30 seconds

BANANA STRETCH FOR TFL AND MUSCLES OF THE LATERAL HIP

• Stand side on next to a doorway and hold onto the side of the doorway with both hands.
• Place the foot that is furthest from the doorway on the other side of the other foot from behind as shown.
• Without bending forwards or backwards – slowly lean your hip outwards from the doorway until a stretch is felt on the outside of hip (you may also feel the stretch through the side of low back and around the armpit area). Hold this stretch for 30 seconds.

STRENGTHENING:

Clam Shell: (glute med strengthening)

• In side lying position, flex both hips at a 45 degree angle and both knees at 90 degrees as shown.
• Place your hand on the hip that’s facing up and carefully raise that knee away from the other knee while keeping your feet together and your core braced to ensure you are stable throughout the whole movement.
• Repeat this for 15 – 20 reps on each side
  Each rep should take about 2-3 seconds to complete, moving fairly slowly and consistently throughout.

GLUTE THRUSTERS: (GLUTE MAX STRENGTHENING)

• Laying on your back with your feet on the ground and your hips and knees bent as shown.
• Brace your core by switching on the muscles around your stomach and keep your head and neck in a relaxed position on the ground (do not raise your head of the ground during the movement).
• Raise your hips off the ground straight up towards the roof slowly and carefully without losing core stability and without swaying to either side.
• Lower your hips back down to the ground in the same manner and repeat a soon as your buttock touches the ground
• Repeat this for 10-15 reps for 2-3 sets
  Each rep should take 1-2 seconds up and 2 seconds down initially. Once you get more confident with the movement without compromising your core stability the “up” motion in the rep can be done quicker.