Iliotibial band syndrome (ITB) is defined as an inflammatory condition of the iliotibial band. The iliotibial band is a band of fibrous tissue that runs down the outside of the thigh. This tendon runs down the side of the thigh and connects to the outside edge of the tibia (upper shinbone), below the middle of the knee joint. The iliotibial band provides stability to the knee and hip and prevents dislocation of those joints.

Signs and symptoms Iliotibial Band Syndrome symptoms range from a stinging sensation just above the knee joint (on the outside of the knee or along the entire length of the iliotibial band) to swelling or thickening of the tissue at the point where the band moves over the femur. The pain may not occur immediately during activity, but may intensify over time, especially as the foot strikes the ground.Pain might persist after activity. Pain may also be present below the knee, where the ITB actually attaches to the tibia.

Causes
Iliotibial Band Syndrome can result from one or more of the following training habits, anatomical abnormalities, or muscular imbalances:
Training habits:
Running on a banked surface (such as the shoulder of a road or an indoor track) bends the downhill leg slightly inward and causes extreme stretching of the band against the femur.
Inadequate warm-up or cool-down.
Increasing distance too quickly or excessive downhill running .
Abnormalities in leg/feet anatomy:
High or low arches.
Overpronation of the foot.
The force at the knee when the foot strikes.
Uneven leg length.
Bowlegs or tightness about the iliotibial band. Excessive wear on the outside heel edge of a running shoe (compared to the inside) is one common indicator of bowleggedness for runners.
Muscle Imbalance:
Weak hip abductor muscles.

Treatment
Reduce training load and intensity so running remains ‘pain free’. Apply ice to the knee (10mins approx every 2-3 hours). Wrap the ice pack in a damp cloth.
Use non-steroidal anti-inflammatory drugs (eg. Ibuprofen) regularly for 5-7 days. Consult your pharmacist or General Practitioner for the recommended dose.
Take massage therapy to decrease tightness of the iliotibial band. You can also try using a rolling band to self-treat.
Gentle stretching of the iliotibial band approx 3 times daily, holding stretches for 30 seconds.

Prevention
Ensure appropriate footwear. You may require motion control shoes or orthotics to control over pronation. Gait analysis can be used to determine this.
Avoid excessive downhill running or running on cambered surfaces.
If running on a track alternate between running clockwise and anti-clockwise.
On full recovery from iliotibial band syndrome decrease the risk of reoccurrence by the following preventative measures:
Gradually increase training intensity.
Continue iliotibial band stretches regularly.
Ensure footwear remains correct.
Ensure adequate strengthening of the gluteals, quadriceps, hamstrings and calfs within your training program.
Avoid excessive downhill running or running on cambered surfaces.
Ensure adequate rest within your training programme.

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