Knee pain is usually associated with a sedentary lifestyle, where muscles and tendons around the joint get weak, affecting its stability. This can trigger aches, debilitating pain and even deterioration. However, people who are into physical activities like cycling, running or playing sports (like football) experience knee pain too. Such pain can be triggered by many factors and is diagnosed by the area where the pain occurs. A mild to severe pain in the lateral side of the knee is a classic symptom of iliotibial band (IT) band syndrome.
A research paper published in StatPearls presents IT band syndrome as one of the causes for lateral knee pain seen among US Marine Corps recruits who underwent training in 1975. Subsequently, it has been diagnosed commonly in long distance runners, cyclists and skiers as well as hockey, basketball and football players.
The iliotibial band tract or the IT band (ITB) is a longitudinal fibrous sheath that runs along the lateral thigh and serves as an important structure involved in movement. It is involved in multiple functions of the hip and knee, namely hip extension, hip abduction, lateral hip rotation, knee extension and knee flexion.
Causes of IT band syndrome
“IT band syndrome is one of the most common overuse injuries,” says Deepshika Goel, senior physiotherapist at Muskan Physiotherapy Clinic, New Delhi. “As with hamstring tightness caused by misalignment or poor posture, tightness can occur in the IT band as well.”
Causes of IT band syndrome are many.
“Major causes include overuse due to repetitive activities like long-distance cycling and running, which stresses the body and demands the involvement of IT band,” adds Goel. “Apart from this, a sudden increase in the intensity, instead of a gradual increment, can also lead to ITB syndrome. Biomechanical issues seen in some people, like inward rolling of foot, can also contribute to this syndrome.”
Goel further explains that even inactive people can develop this condition if they have some malalignment issues like poor foot posture (pronated foot) or pelvic tilt.
Symptoms of IT band syndrome
“The common symptoms are pain along the outside of the knee or the hip, which increases with increased activity,” says Goel. “Knee pain due to age or arthritis generally occurs on the inside of the knee. However, the pain is outside in this condition.”
The pain will be accompanied by swelling and tenderness during knee movements.
A proper warm-up and cooldown routine before endurance activities or sports exertions goes a long way in preventing ITB syndrome.
Treatment
Pain due to IT band syndrome begins as a mild discomfort and can become debilitating over time. If the condition worsens, a musculoskeletal physician or physiotherapist should be consulted who will suggest the appropriate treatment, which usually includes physical therapy along with exercises.
Over-the-counter painkillers and anti-inflammatory drugs are usually prescribed to manage swelling and pain. The initial attempt would be to reduce swelling and restore normal mobility of the joints. Post that, the physiotherapist might suggest manual therapy, which includes stretching and strengthening exercises for the knee and thigh muscles. Foam rolling exercises are usually prescribed to release the stiff trigger points. People can return to their usual physical activities in two to four weeks.
Takeaways
- Iliotibial band or IT band syndrome is commonly seen among those who are into physical activities like cycling, running, playing football, etc.
- Besides over usage of the muscles around the knee joint, biomechanical issues like inward foot rolling and pelvic tilt can also cause ITB syndrome.
- Physical therapy along with stretching and strengthening exercises can help in making a full recovery.
