The iliotibial band is a strong, thick strip of fibrous tissue running down the outside of the leg. Along with the quadriceps (thigh muscles), it provides stability to the outside of the knee joint while running.
ITB syndrome is a common cause of knee and hip pain in athletes, most commonly felt along the outside (lateral) knee and lower thigh during or after running; it can become chronic if left untreated. You can continue with any activity that doesn’t provoke symptoms, so in this case swimming is fine. Running is usually the most aggravating discipline, so it’s wise to reduce your run volume while you identify the underlying cause of the problem.
The first possible cause is running mechanics: poor lower-limb alignment can overload the IT band, specifically if your knee collapses in on your landing foot. Poor control of pronation of the foot and ankle is a cause, so change your trainers regularly and keep your insoles up to date and refurbished. Hip abductor weakness can also be a factor, particularly in the gluteus medius muscle that helps control and stabilise the pelvis as you plant your foot.
A sharp increase in training load or volume can lead to further problems, as can tightness in structures around the hip, including the hip capsule itself, adductors and other muscles around the pelvis.
To treat (or, ideally, prevent) ITB syndrome, try to incorporate the following exercises into your schedule:
Single leg squat for lower limb alignment: Simply squat while keeping the hip, knee and foot aligned. Squat down only as far as you can control the movement. Build up to 3 sets of 25.
Clam for gluteus medius strength: This works the deeper glute muscles that help stabilise the pelvis and reduce hip drop. Lying on your side with your heels together and knees bent, raise
the upper knee, ensuring you work the glute and keep the pelvis still throughout, with no rotation. Progress the exercise with the leg in different positions, and using a resistance band. Build up to 3 sets of 30.
ITB foam roller: Lie on your right side with the roller just under your hip bone. Straighten your right leg, supporting yourself with your arms and left leg. Roll so the pressure moves down the outer side of your leg from hip to knee. Repeat on the left side.
If your pain persists ask a physio to check the diagnosis and devise a treatment plan.
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