Beat ITB Syndrome: Key Tips for Runners

The Iliotibial Band (ITB), a vital fibrous tissue, stretches from the lateral hip down the outside of the quad and attaches just below the knee. Particularly prevalent in distance runners, ITB Syndrome is an overuse injury triggered by a relative spike in training load, such as speed work or hill training. This condition results in pain, swelling, and dysfunction, affecting both recreational and elite athletes alike.

Historically, ITB syndrome was referred to as a friction injury, however recent studies now suggest that the source of pain is caused by compression of tissue between the ITB and the femur.

Identifying ITB Syndrome Symptoms:

A telltale sign of ITB Syndrome is a sharp, localised pain on the outside of the knee, potentially extending up to the hip. This discomfort is pronounced when engaging in activities that flex the knee, such as running, especially downhill, and navigating stairs. Initially mild, the pain intensifies with increased training frequency or intensity, marked by soreness and stiffness after periods of inactivity.

Effective Management of ITB Syndrome:

• Modify running load. Reduce provocative activities, rather than ceasing all together. Areas to consider include reducing speed and hill training, and training within tolerable distances.
• Gait re-training. Consider having a running assessment completed by a professional, to assess causing factors. Using simple cues, such as increasing cadence, can help to reduce the load on the knee.
• Manage fatigue and stress. Focus on adequate nutrition and recovery during your rehab. Consider adding walking intervals between sets to reduce fatigue and improve running gait.
• Strength training. A run-specific Pilates regimen serves as an ideal low-impact solution, focusing on strengthening key areas without exacerbating ITB irritation. Strengthening the glutes and enhancing core stability can help to correct lateral chain imbalances and support running mechanics.
• Plyometrics. Once pain and strength allows, gradually include plyometric training to restore power and control within the lower limb.

Closing Thoughts:

ITB Syndrome, among other knee-related issues, highlights the importance of balanced training, proper recovery, and targeted strength exercises. Incorporating Pilates into your routine can markedly improve muscle balance, running efficiency, and injury resilience. Should symptoms persist, seeking professional guidance is essential to ensure a safe and effective return to running.

REFERENCES: Mucha MD, Caldwell W, Schlueter EL, Walters C, Hassen A, Hip abductor strength and lower extremity running related injury in distance runners: A systematic review., Journal of Science Medicine in Sports, 2017;20(4):349-355 .Falvey, E., Clark, R., Franklyn‐Miller, A., Bryant, A., Briggs, C., & Mccrory, P. (n.d.). Iliotibial band syndrome: an examination of the evidence behind a number of treatment options. Scandinavian Journal of Medicine & Science in Sports, 20(4), 580–587.