ILIOTIBIAL BAND SYNDROME

Written By Andreas Catteau

Description

Iliotibial band syndrome (ITBS) is characterized by pain at the lateral side of the knee. It is often referred to as “runner’s knee”, together with patellofemoral pain syndrome. (Hadeed et al., 2023)

There is a fat pad between the iliotibial band and the lateral femor condyle. This fat pad is most compressed at 30° of knee flexion. It is important to note that there is rather compression than friction of the iliotibial band during knee flexion and therefore there is a suggestion to shift terminology from “friction syndrome” to “compression syndrome”. (Hutchinson et al., 2022)

  • It is the fourth most prevalent running injury, accounting for 7,9% of all running injuries.
    (Kakouris et al., 2021)

  • Risk factors are weak hip abductors (more associated in female runners), more prominent lateral femoral epicondyle, genu varum, running excessively on horizontal or downhill surfaces and sudden increase in running distance or frequency. (Bonoan et al., 2024)

  • 1. DECREASE PAIN

    Modify the activities/running program to decrease the pain level.

    • Running volume ↓ (e.g. 10-20% less than current volume, decrease more if necessary)

    • Amount of elevation ↓ (rather run on flat trails - decrease the amount of downhill running)

    • Running intensity ↓↓ (reduce interval pace and/or interval volume)

    • Modify other activities that put stress on the knee

    • Gait retraining

    2. INCREASE STRENGTH

    Increase the strength of the legs.

    • Train proximal muscle groups (posterior chain + core)

    • Add strength exercises that load the knee joint

    • (and therefore the quadriceps) within comfort

    • Keep aerobic fitness high within comfort (e.g. cycling, crosstraining if possible, swimming, aquajogging...)

    3. INCREASE PLYOMETRICS

    Increase the plyometrics capacity.

    • Start with non-reactive jumps

    • Continue with reactive jumps

    • Progress from long (>0,25s) to short (<0,25s) plyometrics

    • Progress to running-specific drills

    • Load plyometrics in multiple directions

    4. INCREASE RUNNING LOAD

    ncrease the running volume and intensity.

    • Start with building up volume

    • Continue with adding more elevation

    • Continue with adding more intensity

    • Use external (time, distance) and internal (RPE socre) loads to monitore training progression

    • Plan a deload week after every 3 weeks (use 60-70% of the mean load of the previous 3 weeks)

REHABILITATION

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Posts are not medical advice!

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Andreas Catteau
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