Iliotibial Band Syndrome in Runners
The friction created when the iliotibial band—a tough muscle on the outside of the thigh and knee—rolls over the lateral femoral epicondyle (a projection on the lower extremity of the femur) as the knee is flexed and extended causes irritation of the iliotibial band, pain and inflammation in the knee.
The iliotibial band is comprised of dense fibrous connective tissue. As the knee moves extends and flexes, the inferior portion of the iliotibial band passes across the lateral femoral epicondyle. Athletes may be predisposed to this syndrome if this band lacks adequate flexibility.
The diagnosis of iliotibial band syndrome is based on a thorough history taking and clinical examination. During the history taking, the runner’s daily routine, such as mileage, terrain and footwear, is noted. The shoes will be examined for any abnormalities in the wear of the tread and the age of the shoe.
Clinically, runners typically present with tenderness over the lateral femoral epicondyle and report a sharp, burning pain when the lateral epicondyle is presses during extension. The pain is heightened when the knee is at thirty degrees of flexion. The physician will also examine the feet and ankles to make sure that there are no deviations such as having flat feet or high arches. These conditions of the feet could place abnormal amounts of stress on the iliotibial band.
Treatment for iliotibial band syndrome usually consists of ice and rest. Non-steroidal anti-inflammatory drugs and light stretching are also used initially. Once the runner is able to return to activity it may be beneficial to change the running course, avoid hills, or run on the opposite side of the road. In some cases the physician may recommend using orthotics in the shoes in order to correct any abnormalities in the feet. It is also of great importance to maintain flexibility of the hamstrings, quadriceps, calf, and iliotibial band.