Iliotibial (IT) Band Syndrome

Symptoms

• Sharp or burning pain on the outside of the knee.

• Pain typically worsens with activities like running, especially downhill or on uneven terrain.

• Tenderness or swelling over the lateral aspect of the knee, where the IT band crosses the joint.

• Sometimes, pain can also be felt along the outer thigh.

Causes

IT Band Syndrome occurs when the iliotibial band, a thick band of connective tissue that runs from the hip to the outside of the knee, becomes irritated due to friction as it slides over the lateral femoral condyle (outer knee bone) during running or other repetitive activities.

• Overuse: Repeated bending and straightening of the knee, particularly during long-distance running, can lead to inflammation.

• Weak hip muscles: Poor hip strength can alter running mechanics and increase stress on the IT band.

• Tight IT band: A tight IT band may cause increased friction over the knee joint during activity.

Where It Occurs for Track & Field Athletes

• Distance runners are highly prone to IT Band Syndrome due to repetitive knee flexion and extension during long-distance training.

• Hurdlers may also be susceptible due to the side-to-side stresses placed on the knee when clearing hurdles.

• Sprinters who experience sudden increases in training volume may develop symptoms as well.

• Jumpers may experience IT Band tightness or burning from awkward landing, weak glutes, or in high jump where there are some lateral components during the curve run.

Rehabilitation Phases

Phase 1 (0-2 weeks)

• Goal: Reduce pain and inflammation.

• Rest and Ice: Rest from running or activities that cause pain, and apply ice to the outside of the knee for 15-20 minutes, several times a day.

• Foam rolling: Gently foam roll the IT band, quadriceps, and hip muscles to relieve tension.

• Hip and glute stretches: Incorporate stretches for the hip and glute muscles to relieve tension on the IT band.

• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): May be recommended by a healthcare provider to reduce inflammation and pain.

Phase 2 (2-6 weeks)

• Goal: Address muscle imbalances and improve hip stability.

• Hip abduction exercises: Start exercises like side-lying leg raises and clamshells to strengthen the glutes and hip muscles.

• Glute bridge: Focus on glute bridges to improve pelvic stability and reduce strain on the IT band.

• IT band stretching: Continue stretching the IT band, quadriceps, and glutes to maintain flexibility.

• Foam rolling: Use a foam roller regularly to release tension along the outer thigh and hip.

Phase 3 (6-12 weeks)

• Goal: Strengthen the lower body and gradually return to activity.

• Single-leg exercises: Incorporate single-leg squats and lunges to improve knee stability and strengthen the muscles around the joint.

• Running mechanics: Work on proper running form, especially focusing on avoiding overstriding, which can worsen IT band friction.

• Gradual return to running: Start with shorter, low-intensity runs on flat surfaces and slowly progress in distance and speed. Avoid hilly or uneven terrain initially.

Prevention Tips

1. Strengthening Exercises: Regularly include hip abduction and glute strengthening exercises in your routine to prevent IT band strain.

2. Foam Rolling: Consistently foam roll the IT band, quadriceps, and glutes to reduce tension.

3. Proper Running Form: Focus on avoiding overstriding and ensure that you are using proper running mechanics, especially when fatigued.

Exercise Videos