Iliotibial band syndrome (ITBS) is a painful knee condition that takes place more frequently in athletes, especially endurance athletes, like runners, cyclists, and in those who repeatedly squat. The iliotibial band runs along the outside of the thigh, from the pelvis to the shinbone. The band crosses both the hip and the knee and is a structure that helps the knee to bend and straighten smoothly and in a stable fashion. The injury occurs most often because of overuse, as the band gets irritated from repeatedly crossing over the femoral epicondyle, a bony prominence on the thighbone, every time the knee bends and straightens. Those with this condition will notice pain at the outside of the knee, especially when their heel strikes the ground while running.
More About the Iliotibial Band
The iliotibial (IT) band is a dense band of tissue beginning at the iliac crest of the pelvis extending over the hip joint running down the outside part of the thigh, crossing over the outside of the knee and attaching to the shinbone. The iliotibial (IT) band forms from something called the tensor fascia lata and two of the gluteal muscles in the buttock and then it stretches across the knee. Along with ligaments and other joint structures, the iliotibial (IT) band plays a role in providing stability to both the knee and hip.
The band works to help abduct the leg, especially during walking, and it keeps the legs from crossing while walking. The IT band helps stabilize the outside part of the knee through its range of motion. The band moves back and forth when the knee is in motion. While the knee is bent, the iliotibial band is located behind the femoral epicondyle near the knee joint. The band moves forward across the epicondyle when the knee is straightened. With iliotibial band syndrome, the band becomes irritated, and pain is experienced on the outer aspect of the knee.
What is Behind Iliotibial Band Syndrome?
Although iliotibial band syndrome has generally been recognized as an injury caused by the friction that occurs as the band rubs back and forth over the bony epicondyle, recent studies have challenged this concept. When the knee is bent, the iliotibial band is also compressed against the thigh bone, as it braces the knee when stress is placed on it. In instances when the knee is turned or rotated too much, the band can be injured as well. Therefore, another theory is that the injury occurs when the band is compressed at the epicondyle, causing irritation and inflammation there. Additionally, researchers suggest there is a fat pad full of nerves that are compressed between the iliotibial band and the epicondyle as the IT band is pulled towards the epicondyle.
Treatment for Iliotibial Band Syndrome
Conservative treatment, including rest, modification of activity, and physical therapy are commonly recommended. Surgery to cut the IT band and “release” tension are occasionally recommended for cases that will not resolve, but conservative treatment should be sought first. When the IT band and associated muscles are “tight,” a lot of strain is put on the ligaments, making muscle stretching and massage beneficial. The affected ligaments need to be treated as well because all of the involved structures become weakened by the abnormal motion. The joint instability in the hip and the knee needs to be properly diagnosed and treated in order to find the relief and the desired return to function.
Treating Iliotibial Band Syndrome with Regenerative Orthopedics
Regenerative Orthopedics is an effective and promising treatment option that can offer a non-surgical treatment solution for patients with persistent iliotibial band syndrome. Treatment into and around both the hip joint and the knee may very well be needed. If the hip is found to be stable upon evaluation, and the knee alone is affected, then the athlete with iliotibial band syndrome will receive Regenerative Orthopedic treatments to the area on the lower leg where the iliotibial band attaches.
Additionally, if there are parts of the band itself that are tender, these areas can be treated as well. Generally, after just a couple of treatments, the athlete is able to start to work out again. Regenerative Orthopedics offers a successful and much-needed alternative by stimulating the body to repair the supportive ligaments around the joints, heal the iliotibial band, as well as promote cartilage regeneration when necessary. The treatment is safe and effective for athletes suffering from chronic lateral knee pain, such as that experienced in iliotibial band syndrome.