Iliotibial Band Friction Syndrome
Familiar to many runners, this fibrous band runs along the outside, or lateral, portion of the thigh. It is plays a role in hip and knee stability and commonly becomes overstretched and tightens with runners who over train or increase their intensity (distance or speed) too quickly. However, knowledge of this band and the issues it causes is not common knowledge. Unfortunately, runners are not the only group who suffer from IT band issues. Many people, who are not runners, can also experience this same condition. I have personally it in seen bikers, soccer players, triathletes, even the sedentary population.
The question is: What causes this?
Well in order to answer this question lets do a quick anatomy lesson. The IT band arises from a muscle in the glutes called the TFL, or tensor fasciae latae, which plays a role in abduction of the hip (in lay terms, allows the leg to rise up to the side). From there, the IT band runs down the leg and crosses the knee joint. As it passes across the knee joint, it becomes more fibrous, and when it becomes taut it creates friction over the lateral femoral epicondyle (or the bony prominence just above the knee joint).
So how does this happen?
This arises from a fundamental weakness, of the core and gluteal musculature. Allowing the hip to deviate laterally, lengthening and pulling the IT band taut. Weakness in the gluts usually arises from fatigue, especially for athletes. Overtime the adductors, the muscles on the inside of the leg, become tightened, further pulling the IT band taught, which ultimately aides in the acceleration of the syndrome. This overcompensation can also cause changes in the biomechanics of the ankle, causing a syndrome called over pronation (walking on the inside of the foot), which has its own host of issues. Now, after this quick anatomy lesson, you can easily see, that it’s like a house of cards, once one card is pulled out the rest topple over.
Typically, if treated soon after the symptoms arise, IT band can resolve with little residual complication. However, if left untreated (which happens more frequently than it should) the condition becomes chronic and not only does the outcome become less favorable but the treatment becomes more complicated and drawn out. Since the IT band works in concert with the ACL for proper knee biomechanics, and blends some of its fibers with lateral meniscus, it can lead to more serious conditions, besides just the biomechanical changes. Examples include; ACL sprains, meniscal irritation, chondromalacia patella, patellafemoral tracking disorder, and even early degeneration of the knee joint itself. So, needless to say, this should be treated early and with gusto, to ensure that none of the above develops.
Treatment consists of soft tissue therapies like ART, Graston, Kineseotaping and PNF (description of these therapies can be found on this blog in the archives) stretching to most muscles of the lower extremity. Extensive rehab of the lower extremity and core musculature is key, as well as maintaining proper spinal and extremity joint motion with manipulative therapy. Like I mentioned earlier, if treated early, care is less complicated and can resolve quickly but as the length of the condition increases so does the level of complication and length of care. It is always best to seek care earlier on and get evaluated for early signs of IT band issues. Prevention is key!
If you have any further questions or think you need to be evaluated please contact us at Executive Express Chiropractic by phone 415-392-2225 or email me @ email@example.com
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