Iliotibial Band Syndrome

Notice the iliotibial band is not a muscle

A common complaint that presents in my office is pain on the outside portion of the knee.  Some people refer to this as ITB or Iliotibial band syndrome.  It's very common with runners, crossfitters and fitness enthusiasts of all kinds.

So here's what happens.  Typically you are someone who does a very high amount of repetitive exercise.  Historically this has mostly been present with runners.  However lately I've been seeing it with crossfitters, particularly those who practice a very high volume of olympic lifts with dysfunctional technique.  

One thing that runners and crossfitters have in common is a limited amount of single leg strengthening activities. (Pistols being the only exception regarding crossfit).  When you don't utilize single leg strengthening exercises you tend to have limited abilities to stabilize the hip.

With that lack of stability at the hip, there is increased shear motion at the hip joint.  So in an attempt to control the movement, the Tensor Fascia Lata and Gluteus Medius muscles (smaller hip stabilizers) get overpowered and the stress is carried down through the iliotibial band all the way down to the attachment just below the outside of the knee.  So that attachment has to work hard to try to stabilize the knee AND hip and it just gets overburdened and inflamed and bam! You've got ITB syndrome.

It's really a pretty unique syndrome seeing that the iliotibial band is not a muscle, it's just a dense collection of connective tissue.  That's why people that have tried to massage or stretch the IT band end up frustrated because it doesn't work.

Two things to watch out for with ITB syndrome:

1) When the knee travels excessively toward the mid line of the body during any weight bearing movements.  This includes Olympic lifts, running, jumping, squatting, etc.  In the clinical world we call this a 'Valgus Collapse'.  The example picture is a gross example.  It's very common to see a much more subtle inward 'bounce' of the knee especially while returning to the standing position during something like deep squats or Olympic lifts.



2) Exercise Programming that lacks single leg exercises.  Examples of exercises would be lunges, pistols (single leg squat) single leg deadlifts, single leg jumps, etc.

Single Leg Deadlifts

If you have any questions or are in the Boca Raton area and would like to schedule an appointment please dial 561.997.8898 or email me at drscotthoar@gmail.com.  To check out more visit www.Mobility-4Life.com