The following is intended to be an informational source only and are not a means of self diagnosis. Even if you feel that all the signs and symptoms described fit your perfectly, you still need to seek a professional opinion before embarking on a treatment program.

The most common, and often most frustrating running related injury we see in our clinic is Iliotibial Band Syndrome. It is easily treated if diagnosed and treated early before it becomes chronic. This is one of many conditions that often responds well to chiropractic treatment because of the relationship between the pelvis and the muscles that attach to the pelvis. If someone has faulty pelvic mechanics (i.e.—maybe the joints are jammed a bit and they don’t allow for normal pelvic movement) then the muscles that attach to the pelvis will not work as efficiently. If they pull at a slightly different angle, they’ll often get tight and sore. Stretching helps, but unfortunately stretching alone doesn’t last. I’ve seen numerous patients who had tried every stretch, exercise, anti-inflammatory drug, etc… and nothing helped until we addressed the faulty pelvic mechanics. One the pelvis was “straightened out” the stretches became effective and the condition improved. All injuries have a component that needs to be “straightened out”, therefore we also implement various treatment modalities. Interferential current, muscle stimulation, massage, hydrotherapy, laser treatment and ultrasound can be effective tools to aid in the speedy recovery and healing process to keep you in your optimal health and performance.

Understanding Iliotibial Band Syndrome

The Iliotibial Band (ITB) [or the fasciae latae] is a thickening of the fascia, or the outer casing of the muscle, that runs up the outside of the thigh. Fascia is like a sausage casing and the ITB is a thickening of that sausage casing. It originates up by the top of the hip and ends on the outside of the knee. You can feel your ITB when you stand. It causes the outside of your thigh to become very firm and tight while your thigh muscles remain more relaxed. In fact, that’s one of the reasons we have an ITB—it holds our legs straight when we stand, thereby allowing the bigger thigh muscles a chance to rest.
The two main muscles that are addressed when dealing with ITB syndrome are the Gluteus Maximus (one of the buttock muscles) and the Tensor Fasciae Latae (TFL) muscles. The TFL muscles is just a little guy but it does most of the work while we stand, thereby allowing the big guys to rest. You will sometimes heart ITB syndrome referred to as TFL syndrome-the two terms are synonymous.


Signs and Symptoms:

Lateral (outside) knee pain

Pain is often worse after running, especially after climbing hills and often aggravated by climbing stairs
Pain may not be present until mid-way through a run, often not until climbing a hill
Pain can literally bring a runner to her/his knees
Sometimes associated with a “snapping hip”, in which the muscles that cross the outside of the hip can be felt to snap or click during walking or running
Pain may also present as lateral thigh pain more so than knee pain put is rarely focused primarily in the hip or gluteal muscles
Can often be attributed to some form of over-training—doubling one’s mileage, sudden increase in hill repeats, etc…

What’s Going On:

The lateral knee pain is being caused by the ITB pulling up on its insertion on the outside of the knee. Underneath the ITB near its insertion at the knee is a bursa. Bursae are fluid filled sacs that lubricate areas where rubbing and friction occur. When that ITB was pulled tight it put too much pressure on the bursa and that bursa reacted by becoming inflamed and swollen, giving you pain.
The ITB was pulled tight by one of the two muscles mentioned above—the TFL or the Gluteus Maximus. Running up hills, for example, uses more of the glutes than running on flat ground, therefore it will often trigger a bout of ITB pain. That also explains why the pain is often aggravated by hill repeats. The ITB can also be aggravated by running on uneven roads or on tight indoor tracks, running in poor running shoes or if your foot pronates (arch collapses).
If there was an underlying problem with pelvic mechanics, this may have contributed to the ITB problem. Just think about it! You run with both legs equally—why would one leg get ITB pain and the other not?
What To Do About It
First off, if you have faulty pelvic mechanics you’ll have a lot of trouble getting rid of ITB pain on your own. As mentioned earlier, stretching probably won’t do it alone. So, if you’ve been dealing with ITB for more than 2 weeks with just stretching, ice, exercises, etc.. and you’re not improving much, seek a professional opinion.