How do I fix Iliotibial Band Syndrome

How do I fix Iliotibial Band Syndrome2018-07-20T15:39:41+00:00

Iliotibial Band Syndrome is the second most common running injury next to Achilles Tendonitis.  This video and article will help you learn how to fix Iliotibial Band Syndrome.

There are many treatment options available to fix Iliotibial Band Syndrome (ITBS).  It is important to understand that the Ilitotibial Band is like a ligament versus a muscle. The reason this is important is ligaments heal much slower than muscle. The slow healing is frustrating to those that suffer from it and plays a role in it becoming chronic due to the patient constantly aggravating it.   Some Ilitotibial Band Syndrome treatments are less effective than others.  Some are more conservative than others and still some are more expensive than others.  Notice the color of the tendon.  It’s white.  This means it does not have a good blood supply.  Unfortunately everything you need to heal is in blood.  Strategies that increase blood flow will generally help heal Iliotibial Band Syndrome.

ITB causes stabbing pain in the lateral knee

ITBS causes stabbing pain in the lateral knee

Remove the Aggravating Variable to Fix Ilitotibial Band Syndrome

The first thing to do is remove the variable that is either causing your Ilitiotibial Band Syndrome or contributing to it.  For example; if running is irritating it and you keep running it will worsen and may lead to permanent damage of the Iliotibial Band.   Proper diagnosis is critical as Runner’s Knee, Chondromalacia and stress fractures are commonly misdiagnosed as Ilitotibial Band Syndrome leading to poor and ineffective treatment suggestions.

Running will worsen ITBS

Running will worsen Iliotibial Band Syndrome

Rest to Fix Ilitotibial Band Syndrome

Rest from activity, especially those activities that require running, jumping, hiking as these will aggravate Iliotibial Band Syndrome.  No amount of ice or Ibuprofen will help if you continue to not rest and aggravate your Iliotibial Band Syndrome (ITBS).

Do I need Crutches to Fix Iliotibial Band Syndrome?

It is not usually necessary to be non-weight bearing for an extended period.  Casting or other devices that immobilize the Ilitotibial Band for an extended period may be counter-productive.  There are various therapeutic interventions that can significantly reduce the pain associated with running. These include, compression bracing, stretching, strengthening orthotics, self massage (foam roller), myofascial release, ultrasound, proper shoes and orthotics.

Try Getting new Shoes to Fix your Iliotibial Band Syndrome

Sometimes change is good.  By changing shoes you might change how your foot interacts with the ground.  This in turn will affect the amount of rotation and torque at your knee which may be causing your Iliotibial Band Syndrome.  There is no such thing as the “right shoe” or a shoe that is specifically designed to combat Iliotibial Band Syndrome.  Common sense would dictate that if you were going to try new shoes to purchase a new shoe that is dramatically different to what you are currently wearing.  Consider a rocker bottom shoe like a Hoka or a zero drop shoe like an Altra for example.  If you live in San Diego go to Milestone Running Shop for your shoes.  You will not be disappointed.

Over the Counter Orthotics can help Fix Iliotibial Band Syndrome

Over the counter orthotics are a cheap and sometimes effective method of treating Iliotibial Band Syndrome.  If the over the counter orthotic is going to have a chance at being effective it must have a supportive, flexible arch support and be comfortable.  If the orthotic is too stiff, hard, uncomfortable and irritates your foot you will not be able to wear it and it will not help your Iliotibial Band Syndrome.

over the counter orthotics

Over the counter orthotics must have flexible but supportive arches

Custom Orthotics to Fix Iliotibial Band Syndrome

Custom orthotics can be an effective treatment to fix Iliotibial Band Syndrome.  To be effective, they must fit into your shoes, be comfortable and have a flexible, supportive arch as part of the custom orthotic design.  Proper height, density and flexibility of the custom orthotic is critical to it being effective.  If you have custom orthotics that are uncomfortable, do not fit into your shoes or aggravate your feet or your Iliotibial Band Syndrome you will be unable to heal. If you have an uncomfortable or ineffective pair of custom orthotics they may be able to be modified for a fraction of the cost compared to buying new custom orthotics.

Custom orthotics to fix Plantar Fasciitis

SDRI can make new or modify your existing orthotics to fix Iliotibial Band Syndrome

Taping can help Fix Iliotibial Band Syndrome

Taping can be effective in treating Iliotibial Band Syndrome.  A common and effective taping procedure tapes along the ITB to provide support.  Taping can be inconvenient.  There is a more effective method of treating the Iliotibial Band Syndrome.  An ITB compression strap worn in the right location with enough compression may remove some of the stress and pain associated with Iliotibial Band Syndrome.

Kinesiotaping or Rocktaping can be effective when combined with compression strap

Kinesiotaping or Rocktaping can be effective when combined with compression strap

Will an ITB Compression Strap Fix my Iliotibial Band Syndrome

The proper compression strap may help alleviate some of the stress and pain associated with Iliotibial Band Syndrome although it will not fix it.  This can be important if you have an upcoming race or event that you want to get through.  We have found the ITB strap to be effective in mild cases and can also be used in conjunction with Iliotibial Band Taping.

An Iliotibial Band compression strap will not fix Iliotibial Band Syndrome but may help temporarily reduce pain

An Iliotibial Band compression strap will not fix Iliotibial Band Syndrome but may help temporarily reduce pain

Will Stretching Help Fix Iliotibial Band Syndrome

Stretching is typically not an effective therapy to fix Iliotibial Band Syndrome.  However, if used as a part of an overall plan to fix the ITBS than it should not be discouraged.  Stretching like any other intervention must be done correctly to be effective.  In our experience it is not unusual for patients to be over-stretching and actually hurting themselves!

While impressive over-stretching can cause injury

While impressive over-stretching can cause injury

Will Strengthening Help Fix Iliotibial Band Syndrome

Strengthening can help fix Iliotibial Band Syndrome when combined with other interventions such as stretching, foam rolling, ultrasound therapy, myofascial release and orthotics.  Our complete home program can be taught to you in our clinic or you can purchase it for $37 by emailing info@sdri.net

Myofascial Release/Graston/ART/Gua Sha can help Iliotibial Band Syndrome

These are all techniques that apply manual massage directly to the Iliotibial Band.  While this therapy can be effective it is important to apply the correct amount of pressure to ensure you do not further damage the Iliotibial Band.  Too much pressure, too little pressure or the wrong kind of pressure (like using a golf ball) can lead to ineffective treatment and worsening of Iliotibial Band Syndrome.

Myofasial release or scraping can be used to treat Iliotibial Band Syndrome

Myofasial release or scraping can be used to treat Iliotibial Band Syndrome

Ultrasound can help Fix Iliotibial Band Syndrome

Ultrasound can be an effective treatment for Iliotibial Band Syndrome when combined with some or all the above interventions.  Ultrasound can be used to break up scar tissue and increase blood flow into the Iliotibial Band insertion.  The Iliotibial Band is notorious for having a lack of blood flow.  Blood is required for the Iliotibial Band to heal.

Ultrasound can be used to treat Iliotibial Band Syndrome

Ultrasound can be used to treat Iliotibial Band Syndrome

The AlterG is one of the most modern and effective treatments for Iliotibial Band Syndrome and allows the patient to run or walk while their Iliotibial Band is healing.  The AlterG does this by “unweighting” a person until there is not enough pressure on the Iliotibial Band to cause pain.  Once this is achieved the patient can run or walk without aggravating the Iliotibial Band Syndrome.  This allows them to keep up their cardio, continue to train for an event and stimulates blood flow into the ITB insertion to speed healing.

AlterG for Plantar Fasciitis

The AlterG is great at speeding healing of Iliotibial Band Syndrome

Cortisone Injection is not recommended to Fix Iliotibial Band Syndrome

Cortisone is not recommended for Iliotibial Band Syndrome.  Cortisone is a catabolic hormone meaning it breaks things down (as opposed to an anabolic hormone that builds tissue).  While it does break down inflammation it also breaks down tissue, in this case where your ITB inserts on the bone.  This can cause long term damage to the ligament and is therefore not recommended.  However, if you have subiliotibial band bursitis then a one time cortisone shot could prove quite helpful.

Cortisone is not usually recommended to fix Iliotibial Band Syndrome

Cortisone is not usually recommended to fix Iliotibial Band Syndrome

 

Surgery is usually not Necessary to Fix Iliotibial Band Syndrome

Surgery is not usually necessary to fix Iliotibial Band Syndrome.  However, if you go to a surgeon and they recommend surgery……. what did you expect.  Iliotibial Band Syndrome, if treated conservatively will almost always heal and not require surgery.

Surgery is not usually necessary to fix Iliotibial Band Syndrome

Surgery is not usually necessary to fix Iliotibial Band Syndrome

 

If you need more information about Iliotibial Band Syndrome and the treatments that can fix it please email info@sdri.net or call San Diego Running Institute at 858-268-8525 to schedule an appointment.