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Iliotibial band syndrome

What is iliotibial band syndrome?

Iliotibial band syndrome (ITBS), sometimes called runner’s knee, is a recurrent condition suffered by long distance runners (marathon runners, joggers) and cyclists. This tendinopathy is caused by the chronic rubbing of this band on the distal side of the knee during repeated flexion and bending movements.

What are the clinical signs?

A progressive onset of pain is experienced on the distal side of the knee that can extend all the way up to the pelvis. It appears rapidly after starting exercise, after a few kilometers of running, and is often experienced with more intense training, longer strides or after a change of shoes or terrain.

This pain can become increasingly troublesome and develops rapidly during exercise, forcing the athlete to stop running and walk with their leg straight to help reduce rubbing against the knee.

What are the aggravating factors?

Some morphological predispositions can stimulate its onset, of which the most common is genu varum (bow legged) as the band is always under strain. High arches can cause ITBS due to the instability resulting from the smaller load-bearing surface, and sometimes an excessive lateral heel strike. Although less common, valgus foot can also cause ITBS due to the rotation of the tibia inwards stretching this muscle.

Treatment

This syndrome requires a break from sport for about 2 to 3 weeks. In combination with treatment such as cryotherapy and physiotherapy, the podiatrist will propose insoles to correct any static disorder causing the pain, whether it involves the knee or the feet. They will also recommend stretching exercises accompanied by a progressive return to sport, and offer advice on the quality of footwear.

In the case of acute, persistent pain, the physician can propose corticosteroid infiltrations.

Dr Philippe PAILLARD, MD

About the Author:

Specialist in orthopedic surgery and sports surgery, Dr. Philippe Paillard operates on patients with hip, knee, shoulder, elbow or ankle disorders or injuries.

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