ITB Friction Syndrome

Well don’t I just have a lot to talk about today. Finally got to put a name to what is causing all my running problems. Iliotibial band (ITB) friction syndrome is actually one of the most common running complaints. They call runners knee.

For those of you who dont know, the ITB runs down the length of the lateral thigh and lateral knee. Basically a strong band that runs on the outside of the thigh and knee.




As you can see it just takes up quite a lot of the lateral side of the quad and exends up to the hip. No wonder I have been having a lot of pain in my hip etc. This thing is insanely tight.

Basically the short of it is, it is an overuse injury. Your weekend runner doesn’t really experience this as they have long periods of rest and are not stressing the ITB day in and day out. What happens with ITB FS is the ITB can shorten and tighten due to overuse. This causes it to rub against the femoral epicondyle which is on the lateral side of the knee almost dead center.

As you bend your knee with running the ITB flicks over the femoral epicondyle and in time can either become damaged or inflamed. Hence you have what is called ITB FS.

So great I have something treatable. However for 6month we have been doing all the work, which I will discuss later, so that basically I have come to the point I am at know. Before I disucss that lets talk about what causes it. I think this is really important as a lot of beginning triathletes will not do these little things. So I wil merely list them, then we can talk about it in another blog.

- Poor biomechanics (running technique)
- Poor biomechanics (riding technique)
- Weak gluteal muscles
- Weak inner quadriceps
- Worn out or unsuitable joggers
- Thigh muscle fatigue
- Change of running time, distance and/or terrain

So to fix it or stop it occurring you have to keep the ITB loose. Stretch it, learn your ITB stretches. A good one is below.



But also stretch gluts, hamstrings. Trigger point and foam roll. If you don’t know what they are ask a physio, or Google it. Basically you lie on a tennis ball/foam roller and bring it up and down along the ITB and hamstring etc finding tight spots and freeing them out. This stuff really helps with keeping it loose.

However when you get to my stage, it just doesn’t work, plus with all the underlying factors causing the tightness it cannot be fixed without them being resolved.

Today I had a cortisone injection to the ITB just before it crossed the knee, followed by a series of around 10 injections with a Nonsteroidal anti-inflammatory drug (not sure of the name started with T) mixed with an anaesthetic. Relaxes the muscles, reduces the tightness and gets rid of the inflammation. The needles don’t really hurt, similar to dry needling if you have had it before. Expect pain the night time after you have it done. Just an all over ache of the muscle!

I know a lot of people talk about cortisone injections being bad and leading to all these bad scenarios. Yes of course it can happen, but not if you approach it the right way. I have seen my physio Ed Fitzgerald at Qld Sports Medicine Centre for years now. He is great discusses all the issues with it. He stressed that this is NOT the cure. It is to help me be able to do the things I need to get back on track. The physio work, stretching, fixing my bike – the real causes I am getting tight is the only way I can fix it. The shots just get me in a better position to do it.

Great we have an action plan and I know what’s wrong. Now my next blog I will talk about the causes, why I am getting tight and how to avoid it!