Iliotibial Band Syndrome (cont.)

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What causes iliotibial band syndrome?

Iliotibial band inflammation is an overuse syndrome that occurs often in long-distance runners, bicyclists, and other athletes who repeatedly squat. The iliotibial band syndrome may be the result of a combination of issues from poor training habits and poor flexibility to muscle and other mechanical imbalances in the body.

Anatomy issues may include differences in the lengths of the legs (a leg-length discrepancy), an abnormal tilt to the pelvis, or bowed legs (genu varum). These situations can cause the iliotibial band to become excessively tight, leading to excess friction when the band crosses back and forth across the femoral epicondyle during activity.

Runners can develop iliotibial band syndrome symptoms should they make mistakes in their training. Roads are canted or banked with the center of the road higher than the outside edge to allow for water runoff. If a runner always runs on the same side of the road, it produces the same effect on the body as having a leg-length discrepancy. One leg is always downhill compared to the other, and the pelvis has to tilt to accommodate the activity. Running too many hills can also cause inflammation of the IT band.

Bicyclists may develop IT band inflammation should they have improper posture on their bike and "toe in" when they pedal. This can cause the same effect as bowed legs, increasing the angle of the IT band as it crosses the knee, increasing the risk of inflammation.

Other activities with increased knee flexion can cause symptoms and include rowing and weight lifting, especially with excessive squatting.

What are iliotibial band syndrome symptoms and signs?

Pain on the outer side of the knee is the most common symptom of iliotibial band syndrome and is due to inflammation of the area where the band crosses back and forth at the femoral epicondyle. Initially, there may be a sensation of stinging or needle-like pricks that are often ignored. This can gradually progress to pain every time the heel strikes the ground and finally can become disabling with pain when walking or when climbing up or down steps.

Some patients may feel a snapping or popping sound at the knee, and there may be some swelling either where the band crosses the femoral epicondyle or below the knee where it attaches to the tibia. Occasionally, the pain may radiate along the course of the IT band all the way up to the outer side of the thigh to the hip.


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