Iliotibial band or IT Band Syndrome

A few runners with the Norfolk County Pacers have been complaining of iliotibial band or IT Band Syndrome. I had heard of it but fortunately had not experienced it recently so was not able to discuss it intelligently. I did commit to doing some research and I will summarize the results of that research here.

Caveat: Now, I am not medically trained but having run for 30 plus years I do know something about how my body works. Having read the research, I realize that I did have IT Band syndrome some time ago. How I treated it then turns out to have been proper.

Of course, if the pain persists, it may be best to get real medical advice.

What is IT Band Syndrome?
Pain and inflammation on the outside of the knee, where the iliotibial band (a muscle on the outside of the thigh) becomes tendinous, and results in a friction syndrome by rubbing against the femur (thigh bone) as it runs alongside the knee joint. (1)

What causes IT Band?
IT Band syndrome can result from any activity that causes the leg to turn inward repeatedly. This can include wearing worn-out shoes, running downhill or on banked surfaces, running too many track workouts in the same direction, or simply running too many miles. Unlike many overuse injuries, however, IT Band pain afflicts seasoned runners almost as much as beginners. (2)

Self-treatment:
First and foremost rest. Not what a runner wants to hear, but this is true and rest is required.

Second, ice. Need to reduce the swelling. Get comfortable. Put the ice pack on and catch up on some back issues of your favorite running magazine or that novel you have been meaning to get to, or maybe that other book someone mentioned at work.

Third, "oral nonsteroidal anti-inflammatory medication" or in our normal English this would be translated as ibuprofen or another generic equivalent.

After a period of rest you can resume running. The length of the rest period depends upon your injury and how quickly you stopped. If you stopped running right away, then the rest period can be shorter than if you continued running, trying to gut it out.

You need to be careful when resuming your running routine. Start by walking. Gradually build up your walking mileage. If you experience no pain, then you can progress to light running. Run lightly on soft surfaces. Grass or asphalt but not concrete. Avoid running on one side of the road all the time. The camber of the road itself may contribute to the injury.

Stretch before and after walking (at first) and then your running. The intent is to strengthen the muscles in the legs and hips to reduce the strain on the IT Band itself.

Stretching exercises:
The best I found with simple instructions and photos of the stretches is from Running Times

On-going Treatment:

1. Most importantly, always decrease your mileage or take a few days off if you feel pain on the outside of your knee.
2. Walk a quarter- to half-mile before you start your runs.
3. Make sure your shoes aren't worn along the outside of the sole. If they are, replace them.
4. Run in the middle of the road where it's flat. (To do this safely, you'll need to find roads with little or no traffic and excellent visibility.) (Or run on one side part way, then switch to run on the other side to balance the time and effort on your legs.)
5. Don't run on concrete surfaces.
6. When running on a track, change directions repeatedly.
7. Avoid doing any type of squats.
8. Schedule an evaluation by a podiatrist to see if you need orthotics.

Additional sources of information on IT Band:

• A good web site put together by a runner who suffered with IT Band.
• Another good site, more professionally done.
• Physician and Sports Medicine site.
• One simple page, good photos of the anatomy involved.
• Another good sports medicine site.
• The Sports Injury Clinic site.