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{{DISPLAYTITLE:Iliotibial band syndrome (ITBS) }} [[File:ITBS.png|right|thumb|300px|]]Iliotibial band syndrome (ITBS) generally causes pain in the outside of the knee, with the pain often arising after a couple of miles of running. The Iliotibial band (ITB) runs from the crest of the hip bone (Iliac) to the top of the shin bone (tibia) near the knee, hence the name. You can see the ITB in green in the picture belowITBS is a common issue for runners, with research suggesting it impacts about a 6<sup>th</sup>of all runners<ref name="Noehren-2007"/>. I have only had limited experience Sometimes runners ITBS is confused with ITBS[[Knee Pain| pain under the kneecap]], but I have found that treating ITBS is normally specific to a small area on the site outside of the pain (near knee, and is most noticeable when the knee) or is flexed to 30 degrees. There are a number of possible approaches to treating ITBS, but even with the ITB as it runs down numerous research studies into ITBS, the thigh to be ineffectivequality of information is remarkably limited<ref name="AderemLouw2015"/>. * '''The TFL'''. Instead, I have found it much more the most effective treatment for ITBS is to focus on the Tensor Fasciae Latae (TFL), shown below in red. I use the [[Thumper]] to massage [[Massage]] the TFL, which can be quite painful, but I works well, as massaging with my fingers. This massage should be combined with strengthening the TFL. One of the best exercises for this is the 'Frankenstein march'. To do this you will need a short resistance band like this <jfs id="B0000AJ057 " noreferb="true" n="resistance band set"/>. Put the band around your ankles and walk with your feet about shoulder with apart. You need enough tension on the strap so that when you walk, you have found to put an effort into keeping your feet apart. Walk a short distance, keeping your feet pointing straight ahead. Go far enough that my you can feel the effort in your hips, but don't overdo it. * '''The Glutes'''. The TFL/ITB generally works together with your glutes, so if the glutes are weak, the TFL/ITB has to work harder. The hip abductors are your glutes (Gluteus Maximus, Gluteus Medius, & Gluteus Minimus), plus the TFL. The word "abduct" means to "lead away" and the hip abductors pull your legs outwards, away from your midline. Like the TFL, the Glutes need [[Massage]] and strengthened. The Frankenstein March also works to strengthen the Glutes. * '''Mobilize the ITB'''. [[Massage]] of the ITB from the hip to the knee can help mobilize the ITB. Using the [[Foam Roller]] to massage the outside of the thigh can be quite painful, so using your other leg to reduce the pressure is often needed to keep things bearable. You can also use your hand to massage the ITB and surrounding muscles (vastus lateralis and biceps femoris.)* '''Ice'''. Using [[Cryotherapy - Ice for Healing|Ice]] on the site of the pain can help reduce the swelling and pain, but it does not seem to help address the root cause. You can also ice the TFL, which may be more effective. * '''Avoid NDADs'''. [[NSAIDs and Running|NSAIDs]] like ibuprofen will help mask the pain and can reduce the inflammation of ITBS symptoms subside very rapidly after treatment, but they can also retard the healing process. * '''Replace Your experience Shoes'''. It is possible for badly worn [[Shoes]] to change your biomechanics enough to trigger ITBS. It's worth checking your [[Shoes]] for excessive wear; not the tread on the outsole, but the midsole foam. Feel the thickness of the sole and see if it is significantly thinner in some sections, such as where the ball of the foot presses.* '''Biomechanics'''. Poor biomechanics can cause ITBS, so having someone evaluate your [[Running Form]] may differ from minehelp. Another approach is to have someone video tape your running and check it for good form. You should check your [[Cadence]], but consider this as the correct Cadence can resolve many biomechanical issues like [[Overstriding]]. * '''Avoid Fuel Belts'''. Though the pain of ITBS is felt near the knee, the origin of the ITBS is at the hip. Therefore anything that presses on the ITB high on the leg, or worse the TFL, can cause or aggravate ITBS. If you have been wearing a method fuel belt, or any other type of treatment belt around the hips, I'd recommend not wearing it until the ITBS has completely recovered. If you feel the fuel belt is worth it, try reintroducing it and see if the ITBS reoccurs. * '''Foot angle'''. Personally, I've found that if you suffer from my feet are turned even slightly outwards (AKA lateral rotation or duck feet) it can trigger ITBSquite rapidly. I suspect this is because this outward rotation causes the knee to tend to bend inwards and the muscles have to pull on the ITB to maintain stability. =References=<references><ref name="AderemLouw2015">Jodi Aderem, Quinette A. Louw, Biomechanical risk factors associated with iliotibial band syndrome in runners: a systematic review, BMC Musculoskeletal Disorders, volume 16, issue 1, 2015, ISSN [http://jfsavagewww.smugmugworldcat.comorg/photosissn/808647080_WdfBH1471-2474 1471-L2474], doi [http://dx.doi.org/10.jpg1186/s12891-015-0808-7 10.1186/s12891-015-0808-7]</ref> (My apologies for my poor drawing skills <ref name="Noehren- other images 2007">B. Noehren, I. Davis, J. Hamill, ASB clinical biomechanics award winner 2006 prospective study of the ITB and TFL can be found biomechanical factors associated with Googleiliotibial band syndrome., Clin Biomech (Bristol, Avon), volume 22, issue 9, pages 951-6, Nov 2007, doi [http://dx.doi.org/10.1016/j.clinbiomech.2007.07.001 10.1016/j.clinbiomech.2007.07.001], PMID [http://www.ncbi.nlm.nih.gov/pubmed/17728030 17728030]</ref></references>[[Category:Injury]]