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The Iliotibial Band (ITB) is a thick band of connective tissue that runs down the outside of the thigh. It plays an important role in stabilizing and supporting the knee and hip during activities such as walking, running, and cycling. Iliotibial Band Syndrome (ITBS) is an overuse injury caused by repeated bending and straightening of the knee, making it especially common among runners and cyclists.
Causes of Iliotibial Band Syndrome (ITBS)
The causes of ITBS generally stem from overuse or excessive strain on the ITB, leading to irritation or inflammation. Two primary mechanisms proposed for the development of ITBS include repetitive traction and repetitive friction.
Repetitive traction happens when the ITB is subjected to repetitive stress because it has to work harder to stabilize the lower limb during movement, especially in activities that involve frequent bending and straightening of the knee, like running.
Repetitive friction happens when the ITB moves back and forth over a bony protrusion on the outer part of the femur (thigh bone), leading to irritation of the ITB and inflammation of the bursa that lies between these two structures.
Other Contributing Factors:
Tight or Weak Muscles: Tightness in the ITB or surrounding muscles (e.g., hip flexors, quadriceps, hamstrings) can put extra stress on the ITB, increasing the risk of inflammation.
Biomechanical Issues: Problems like leg length discrepancies, poor running form, knee misalignment, or excessive foot pronation can misalign the lower leg, forcing the ITB to work harder.
Previous Injury: Past knee, hip, or ankle injuries can alter movement patterns, putting additional strain on the ITB.
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Signs and Symptoms of Iliotibial Band Syndrome (ITBS)
Pain or tenderness on the outer side of the knee, which may radiate up to the hip.
Redness or swelling on the outside of the knee.
A sensation of tightness or stiffness along the ITB.
Pain that worsens with activity, especially when bending the knee, running uphill, or running on uneven surfaces.
Treatment and Management of Iliotibial Band Syndrome (ITBS)
Podiatrists play a key role in the treatment and management of ITBS by addressing underlying foot and lower limb issues that contribute to the condition.
Footwear and Orthotics: Assessing footwear and prescribing custom orthotics to correct issues like overpronation or improper foot alignment.
Biomechanical Assessment: Conducting gait analysis to identify abnormal movement patterns and recommending corrections to reduce ITB strain.
Strengthening and Stretching Exercises: Recommending strengthening exercises for the weak surrounding musculatures, as well as stretching to improve flexibility and relieve ITB tightness.
Shockwave therapy: Aims to release muscular tension and trigger points, as well as promote healing at the inflamed site.
Education and Prevention: Providing advice on proper footwear, movement mechanics, and injury prevention techniques.
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