Iliotibial band injuries for runners

How to treat iliotibial running injuries

Running injuries to the iliotibial band (ITB) are common causes of knee and hip pain. The iliotibial band is a band of collagen fibres which are not elastic in nature. It attaches to the pelvis at one end and just below the knee at the other and runs on the outside of the thigh. It is also attached to part of the thigh bone. As a result, problems in this area can cause discomfort to a number of the body's key running areas so it's important to know how to combat such running pain. Here's our guide to preventing and overcoming iliotibial band running injuries.

When standing, the ITB helps us to remain upright. On bending the knee and running, the position of the ITB changes slightly and it alters the workload of other muscles, especially those which bend the hip. If the ITB becomes tight it can lead to problems. Several different groups of athletes can get a tightening of the ITB, with one of the most common being adult runners – especially distance runners.

Common runners' problems and symptoms of a tight ITB include...

Snapping or clicking around the hip as the tight band flicks over the thigh bone during running.
Trochanteric bursitis – constant rubbing of the ITB on the pocket of fluid – the bursa, at the top of the femur can lead to inflammation and pain on the outside of the hip. It is often painful to lie on the affected side after running.
Pain on the outside of the knee during and after running.
Anterior knee pain during running.

Causes of this running injury include...

Wearing shoes for running which are worn on the outside edge, as this may put extra stress on the outside of the knee, causing an overstretch.

An imbalance of the muscles of the thigh.

Running on an uneven camber – on roads or on uneven ground.

A sudden increase in running training.

Insufficient warm-up before running.

Treatment and management of this running injury
Firstly check your running footwear, especially running shoes. Alter the training pattern, check for the camber on the training area, reduce distances and reduce the length of your stride to reduce the pull on the ITB. Also reduce the number of training sessions until symptoms start to settle.

Stretching exercises
Done initially as a treatment and then continued to include them as part of the running warm-up and cool-down sessions in your training when the symptoms have subsided along with quads, hamstrings and calf stretches.

Heat
A warm pack or covered hot water bottle over the sore area may ease symptoms and relax the soft tissue.

Iliotibial band stretch exercise for runners
Standing, cross your left leg behind the right leg. Push your left hip out to the side as you bend your body to the right. You should feel a stretch along the outer left hip and thigh. Hold for 20 seconds and repeat on the other side.

If symptoms persist, consult a suitable professional – i.e. a doctor or chartered physiotherapist as further assessment and treatment may be required. It may be wise to consult a professional as to specific stretches as it is difficult to describe easily how to do the stretches.