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What is ITB Friction Syndrome?

Updated: Jun 25

ITB Friction Syndrome, or Iliotibial Band Friction Syndrome, or ITBFS, is a condition whereby the iliotibial band is inflamed due to too much friction. This hardband, commonly referred to as the IT band, extends from the hip to just below the knee in the outer area of the thigh.


This article provides an overview of ITB friction syndrome covering the following key areas:


- The IT band is an abbreviation for the iliotibial band, a muscular fascia extending along the outer part of the thigh to the knee.


- Friction syndrome in ITB is caused by factors such as poor biomechanics, overtraining, muscle imbalances, ITB tightness, and direct impact on ITB. 


- Symptomstherapy

- Risk Factors

- Diagnosis

- Treatment Options

- Prevention

- Outlook


The IT Band stands for the iliotibial band, a thick, fibrous tissue that runs down the outside of the thigh from the hip to the shin. IT band also known as iliotibial band is a dense connective tissue that originates from the outside of the anterior triangle of the hip and descends the lateral aspect of thigh to the shin. It starts by arising from the pelvic bone and the gluteal muscles and passes across the hip joint to attach below the knee.


The IT band is responsible for stabilizing the hip and the knee during activities such as running. This also aids in the stretching out of the hip joint. As it passes over the sharp edge of the lateral femoral condyle on the outside of the knee and flexes and extends the knee, the meniscus is exposed to a great deal of rubbing and friction.


ITB friction syndrome can be caused by several factors, which include:  


ITB friction syndrome is characterized by inflammation and pain caused by the continued friction between the iliotibial band and the lateral femoral condyle as the knee flexes and extends during activities that require repetitive knee movements. This, in turn, causes the bones to grind against each other, resulting in abrasion and inflammation.


ITB friction syndrome is most commonly traced to activities that affect frequent flexing of the knee, including running, cycling, and hiking. Runners are particularly vulnerable to developing this pathology as the foot strike and push-off phases of the gait cycle produce shear on the lateral aspect of the knee joint.


Symptoms


The most apparent sign of ITB friction syndrome is discomfort on the lateral part of the knee or on the thigh area.



Other symptoms may include:


- The embrace of tenderness on the outside of the thigh

- Pain and/or swelling along the IT band

- Pain during or after engaging in activities such as walking, running or climbing stairs

- Pain during weight-bearing, such as walking or some other form of exercise.

- Aching that increases in intensity as the affected area remains in use

At times, some noise can be heard, or there may be a snapping or a popping feeling as the knee moves.


Risk Factors 


Certain factors can increase risk for developing ITB friction syndrome:


- Running – particularly, increasing the number of miles one runs per week without adjusting for it.

- Leg length discrepancy

- Tight IT band

- Lumbar and hip extensor muscle imbalances and hip abductor and external rotator muscle strength deficits

- Bowlegged alignment

- Repetitive racing, either uphill or downhill

- Worn out shoes

It is also important to note that the females are thought to be affected more than the males.


Diagnosis


Diagnosis of this condition can be done through examination of the knee and hip joint, evaluating the knee and hip range of motion, walking pattern and palpation of the IT band. They will also require the patient to describe any symptoms and recreational activities or sports the patient participates in.


In some cases, the patient might be given imaging scans such as x-rays or MRI to check for other causes of lateral knee pain, including bursitis and stress fractures, among others.


Treatment Options


In most of the IT band friction syndrome cases, non-surgical interventions can be employed, which include rest, application of ice packs, pain relievers, physiotherapy, and alteration of activities.



Specific treatment approaches may include:


- Rest

- They also use ice packs to help manage pain and inflammation.

- Some medicines include Non-steroidal anti-inflammatory drugs, for example ibuprofen

- Some of the most effective stretching and foam rolling exercises.

- Therapists may suggest some sets of exercises for the hip and glutes, to make the muscles stronger.

- Taping techniques

- Dry needling or massage is another technique of treating the patient and can be defined as the application of pressure to muscle tissue, tendons, ligaments, or skin to cause the release of tension.

- Injections with corticosteroids in instances where the pain is unbearable


Prevention


To help prevent ITB friction syndrome:


- Prepare yourself for exercising by performing some stretches and light exercises.

- Gradually intensify the training level

- Massages the IT band frequently through stretching and foaming roller. 

- Increase the strength of muscles that are responsible for the outer rotation of the upper leg.

- Shoes are an essential part of the running gear. The optimal time to change them is every 500-800 kilometers

- Downhill train conservatively


If a runner has an IT band problem, he should shift from regular running to more elliptical training and cross-training.


Outlook


The above-discussed ITB friction syndrome can be effectively cured, and most patients regain their complete body strength. Symptoms are usually resolved within the first six weeks of treatment, with the patient experiencing a progressive recovery. The main goal of treatment is physical therapy and the reinstatement of movement and activity in a gradual manner. Surgery is not often called for and is only used as a last resort for those who do not respond to other treatments in the next 6-12 months.


Flexibility of the IT band and friction reduction can be achieved through; preventative stretching procedures, muscle strengthening, failure to over work the muscles and so on. It is, therefore, essential to be well informed of the signs and symptoms of friction syndrome of the ITB to enable one seek treatment early enough.

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