What Is ITB Syndrome and How Can You Prevent It?

Dr. Dan Geller answers the most common questions about ITB Syndrome

One of the most common injuries distance runners face, ITB Syndrome (or Iliotibial Band Syndrome), happens when the Iliotibial Band is tight, strained or aggravated.

“Weak hip abductor muscles play a large role,” said Dr. Dan Geller, a surgically-trained foot and ankle specialist focusing on sports injuries, post-traumatic reconstruction, and chronic conditions of the foot and ankle. “These weak hip abductors are part of a commonly seen pattern of weak core muscles.  It is these weak muscles that lead to muscle imbalance in the athlete.”

As athletes start increasing their mileage or intensity, hip abductors are at risk of becoming fatigued and it’s then that the extra stress falls to other muscles.

“Strengthening of hip abductors, as well as core and gluteus muscles and stretching the iliotibial band and structures that attach to it are usually the fundamental key to recovering from the often debilitating injury,” said Geller.

Symptoms and Causes

“Typically an athlete with ITB syndrome will present with a pain or aching on the outside part of the knee,” said Geller. “This pain will usually occur at some point during the middle or end of a run.” Runners aren’t the only ones who experience ITB syndrome.

“Cyclists may also develop iliotibial band syndrome from overuse and I have often seen relief to this injury by slightly lowering the saddle or even repositioning the foot on the cleat with heel oriented to 3 degrees inward,” said Geller. “The function of the muscles inserting into the iliotibial band is to abduct the leg.  If the hip abductors are weak then the iliotibial band is being overworked.”

Possible Causes:

  • Weakness and imbalance in the hip abductor muscles.
  • Weak core muscles.
  • Sudden increase in mileage.
  • Increase in track or interval running.
  • Tight iliotibial band or a tight capsule and tight thigh muscles.

How to Prevent ITB Syndrome

  • Don’t increase mileage or intensity too quickly and if you feel pain on the outside of your knee, rest for a few days.
  • Warm up and cool down properly from workouts, be sure to stretch.
  • Wear proper sneakers and check that they’re not worn down.
  • Try to run on mostly flat surfaces and change directions when running on a track
  • If pain persists, see a medical professional

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