ITB Pain/Lateral Knee Pain
What is it?
ITB or lateral knee pain is pain on the outside of your knee and is common in runners and cyclists. It is often worsened at around 20-30 degrees of knee flexion.
ITB pain was previously thought to be a friction syndrome, is now understood to be more of a compression issue. This compression is likely to be of the sensitive fat pad between the ITB and lateral femoral condyle (side of the knee).
What is the ITB?
The ITB is dense connective tissue that originates from
· The extension of the TFL, glut med and max tendons
· Several points of the ilium (pelvis)
It has multiple insertions around the lateral knee including:
· Multiple points on the tibia (shin bone)
· Head of fibula
· Patella (kneecap).
· Most importantly ITB inserts broadly along the thigh bone & several points on the lower portion of the femur.
Why is the anatomy important?
STOP STRETCHING OR ‘RELEASING’ YOUR ITB!
Studies have shown that the ITB is unable to be stretched to any meaningful degree due to its complex tissue type and the location of insertion along multiple points of the femur and knee.
What does the ITB do?
The ITB works to help stabilise the hip by resisting certain hip movements (such as adduction and internal rotation of the hip). It also helps with stability around the knee by passively limiting internal rotation and forward translation of the tibia (shin bone).
What causes ITB pain?
As noted above, this is a common condition in runners & cyclists who repeatedly go into 20-30 degrees of knee flexion. It is likely to be caused secondary to reduced strength of hip stabilisers, which results in knee valgus (knees coming together) and then subsequent impingement of the fat pad.
How do we treat this?
· Progressive strengthening program of the hip stabilisers, such as the abductors, external rotators and extensors.
· Assessment of foot mechanics
· Education and modification to load/training programs
Treatment should be progressive and take into account each persons activity level, goals and symptoms.
For Treatment or Advice
Book Now or
Email - alanna@korumburrappc.com
Call or Text - 0412 515 524
Written by
Alanna Hickey
Owner & Physiotherapist
Korumburra Physiotherapy & Pilates Clinic
References:
Geisler, P. (2020). Iliotibial Band Pathology: Synthesizing the Available Evidence for Clinical Progress, Journal of Athletic Training. https://doi.org/10.4085/JAT0548-19
Fairclough, J. The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome, Journal of Anatomy, 2006 Mar; 208(3): 309–316. doi: 10.1111/j.1469-7580.2006.00531.x