Ilio-Tibial Band Syndrome (ITBS)
Lateral
knee pain in runners is often caused by Iliotibial Band Syndrome
(ITBS). The Ilio Tibial Band is a thick broad tissue which
runs from the outside of the pelvis (over the hip) down the thigh
and inserts just below the knee (on the outside). The symptoms
range from a stinging sensation on the outside of the knee (most
common), or along the entire length of the Ilio Tibial Band, to
swelling. The pain will worsen with activity when the foot strikes
the ground and overpronates (where the foot "spreads"
to the floor), especially if you overstride or run downhill and
may persist afterward. A single workout of excessive distance
or increase in mileage can aggravate the condition.
This
condition is one of the worst injuries to have because of the slow healing
properties of tendon tissue. In addition, not decreasing training or activity
contributes to the slow healing process.
Resolution can easily take 6 months?1.5 years.
Other causes of the injury are: 1-The key element and most single common entity is overpronation
in one foot
greater than the other. Typically the patient has a "functional
shortage" on one side, where one leg is pulled higher into the hip
joint (acetabulum) as a result of rotation of one of the hip bones (ileum)which
began early in life.
2-Running on a banked surface, which causes the downhill leg to bend slightly
more inward and cause extreme stretching of the band. 3-Inadequate warm up or cool down
4-Running excessive distances or increasing mileage too quickly
5-Anatomical abnormalities i.e limb length discrepancies, bowlegs and tightness
about the ITB
Treating Ilio Tibial Band Syndrome should consist of the following:
-
Decrease mileage
-
Ice knee after activity [do not apply ice directly]
-
Alternate running direction on banked surface
-
Stretching the ITB [Be
careful to stretch to tension and not overstretch
I recommend stretching 2x/day]
-
Any support to help minimize overpronation.
The Silicone Dynamic Orthotic "cushion" precisely minimizes overpronation.
This optimal position of the feet takes
stress and strain off the repetitive stretching of the Ilio Tibial Band. It must be
understood that even with the best of control one can still be vulnerable
due to overtraining. The difference is that with biomechanical control
the likelihood of reinjury is lessened.
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