Iliotibial Band Syndrome (ITBS)
Functional Anatomy
The iliotibial band has three sites of origin:
- Iliac crest
- Superior gluteus maximus (the gluteus medius/minimus lie deep to the ITB)
- Tensor fascia latae
And three sites of insertion:
- Lateral patella
- Gerdy’s tubercle (tibia)
- Lateral femur (linea aspera)
What is the purpose of the ITB?
- Humans are the only mammals that possess an ITB, this is developed to provide energy store and release.
- The ITB stores up to 14% of the total work during running, only second to the achilles tendon (~35%).
- A tight ITB is more functional as it resists knee varus (outwards) torques as well as providing optimal energy store and release
What Is Iliotibial Band Syndrome (ITBS)?
ITBS often presents as pain on the lateral (outside) aspect of knee and is one of the most common running related injuries. While this pain is primarily in this region, it can also radiate up or down the leg. The onset of ITBS is often after prolonged activity, for example 3km into a run.
What Causes Iliotibial Band Syndrome (ITBS)?
How Can Physiotherapy Help?
Firstly, your physiotherapist can identify and diagnose your injury. This is essential to ensure optimal recovery and the correct rehabilitation strategies. Other common running related knee injuries include:
- Patellofemoral pain syndrome (PFPS)
- Fat pad impingement
- Gluteal tendinopathy (referral pain)
- Femoral bone stress fracture
- Lumbar spine (referral pain)
Your physiotherapist will confirm your diagnosis of iliotibial band syndrome (ITBS) through a combination of detailed subjective questioning alongside appropriate special tests. After this they will educate you on the condition and answer any questions that you may have. Historically ITBS has been treated through heavy and slow resistance training followed by return to running. However, the ITB is responsible for energy store and release, hence, making plyometric training essential to avoid reinjury
The rehabilitation program will be tailor-made to the discrepancies found in the assessment and corrective strategies required to prevent future injuries. The rehabilitation program will focus on building up capacity through each stage.
Each stage will focus on specific exercises to target the relevant goal. Manual techniques may also be used to further facilitate rehabilitation.