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What is Iliotibial Band Syndrome by Jeff Schmidt

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Ever have a severe pain in the side of the knee when performing activities such as walking, running, or cycling? Iliotibial Band Syndrome (ITBS) is a pain in the side of the knee and is thought to be an overuse injury. The iliotibial band (IT band) is a thick, dense band of fibrous connective tissue. The band is attached at the hip bone and runs down the lateral side of the thigh and attaches to the tibia (shin bone). The purpose of the IT band is to stabilize the outside of the knee. Since the IT band stabilizes the knee during extension and flexion, it is in constant use when walking, running, or cycling. This article will go over some of the symptoms, causes, diagnosis, treatment, and outlook of ITBS.

The symptoms of ITBS are significant, sharp, cutting pain on the side of the effected knee. The most notable symptom is pain when walking down steps. Typically, as with most overuse injuries, the pain increases with activity and can be debilitating. Each bend of the knee causes the band to slide from behind of and to the front of the femur. The constant sliding over the bony part on the outside of the knee causes friction and inflammation.

The causes can be from walking or running on uneven surfaces, running downhill, running around a track in the same direction too often, or as simple as worn out shoes. From my own experience, I became afflicted with ITBS when walking an excessive amount of miles on the cambered surface of ballast on railroad tracks for my job. The pain of ITBS can be so severe that it renders one from normal activity for weeks, or even longer.

It is suggested to get a physical examination by a doctor. The doctor may move and bend the leg at the knee to try and recreate the pain. Pain could also be felt by palpating the side of the knee when bent at a 45-degree angle.

Treatment for ITBS varies and can take a long time to show improvement. The first step in the healing process is taking NSAIDs such as Aleve or Ibuprofen and the RICE method (rest, ice, compression, and elevation). Simple stretching techniques can be used to elongate and loosen the IT band. Another suggestion is to make use of a foam exercise roll which is commonly used in physical therapy. The goal behind using the foam roll is to loosen up any scar tissue that may have built up. The use of the foam roll is very painful because the person is to put all their weight on the IT band, then roll up and down the length of the band to loosen it up. For stubborn IT bands, it may be recommended to receive cortisone shots to decrease the pain. Still, it may be necessary to have surgery in order to relieve the person of their pain. One surgical method is to poke a bunch of holes in the band near the femur in order to essentially loosen it up. However, this method is a lot like trying on a larger shoe, instead of removing the rock.

There is a lot of controversy when it comes to ITBS. For starters, the subject is not a well-studied one. For most people, ITBS eventually goes away with enough rest and care to prevent it from happening again. However, there are many people that cannot get rid of it. I am one of those examples. ITBS is a chronic condition in both of my legs. A very good article on ITBS is SaveYourself.ca • Sensible advice for aches, pains & injuries. It explains how the cause of the pain is an inflamed bursa. In order to be cured, there are a couple of surgeries that can be tried, but there are only a handful of doctors in the world who do it. One of the procedures is to remove the thin, white layer that has formed on the bursa due to the overuse and friction on it; however, one of the problems is that no one is certain if there is a bursa there. Some say there is, while others say there isn’t.

To date, the future outlook on Iliotibial Band Syndrome and the permanent cure of it (for those stubborn healers) is not good. There just simply is not enough awareness and practice of the IT band to do anything about it.  As mentioned, most people end up okay and can return to normal activities while practicing prevention to keep the pain at bay. For those people like me, we need to fly to California or Europe to have the proper surgical procedure done to rid us of our pain.



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  • http://saveyourself.ca/articles/confused-about-itbs-location.php
  • http://www.webmd.com/pain-management/knee-pain/tc/iliotibial-band-syndrome-topic-overview
  • http://orthopedics.about.com/cs/sportsmedicine/a/itbs.htm



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