- ITB syndrome causes a diffuse pain across the outside of the knee, roughly in line with the kneecap, as the knee bends to 40° while weight bearing
- There is no swelling and usually no tenderness to touch, although there may be a tender spot if the bursa is affected
- The leg can feel weak or like it will give way when the pain grabs
- If pain occurs while running, the pain causes the supporting muscles in the leg to reduce their activation (known as pain inhibition) which leads to further pain
- The best response is to stop and walk for a short period (1-2min) before recommencing running at a faster pace
- Anti-inflammatory tablets or gels don’t help but a strong heat or cooling gel (eg. Dencorub) can mask the pain, improving movement patterns and reducing the irritation to ITB
- Improving leg rotation and foot pronation control with more structured footwear or orthotics will reduce the pain quickly and increase the rate of improvement from exercises
- This assists in getting an immediate response to exercises and can be weaned off as the muscle control improves
- The primary mechanism behind ITB syndrome is actually inwards leg rotation (from uncontrolled pronation or hip movement), not hip/ pelvis drop
- Foam rolling at ITB can aggravate a sensitive bursa (pad) behind the ITB and worsen the condition
- ITB syndrome is not due to shortened ITB length and stretching an ITB doesn’t change its length or pressure on the side of the knee
WHAT ELSE COULD IT BE?
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