Iliotibial Band Syndrome

Iliotibial band syndrome is an overuse injury resulting from the inflammation of the iliotibial band. An iliotibial band is a tough group of fibers that begins at the iliac crest of the hip and runs along the outside of the thigh to get attached to the outer side of the shinbone, just below the knee joint. Its function is to coordinate with the thigh muscles and provide stability to the knee joint. Iliotibial band syndrome occurs when the iliotibial band and the lower outside portion of the thighbone at the knee joint rub against each other. It commonly occurs in athletes, cyclists and runners.

Iliotibial band syndrome can occur by quickly increasing distances with running or biking-type activities. Other predisposing factors associated with the injury include running on uneven surfaces, wearing improper fitting shoes, uneven leg length, muscle imbalance, over pronation of the foot and bowed legs.

Children with iliotibial band syndrome may experience pain on the outer side of the knee, swelling at the site of injury, and popping sensation when the knee is bent and then straightened. Pain may worsen after running, climbing stairs and walking, and reduce when at rest.

The goal of treatment is to reduce inflammation and relieve pain. The treatment options include:

• Rest: Allow the joint to rest to reduce the inflammation. Do not encourage your child to run or participate in any physical activity that may worsen the pain.
• Ice application: Ice packs should be applied to the site of injury to help diminish swelling and pain. Ice should be applied over a towel to the affected area for 15-20 minutes, four times a day for several days. Never place ice directly on the skin.
• Medications: Your doctor may prescribe non-steroidal anti-inflammatory drugs to reduce the pain and swelling.
• Foam roller myofascial release: A foam roller is used underneath the tight iliotibial band to loosen it. Although this is painful, it is one of the most useful stretches to relieve the tissues.
• Physical therapy: Physical therapists will teach your child stretching exercises and techniques to loosen the tight structures. One of these exercises is done by holding the affected knee close to the opposite armpit while keeping the other leg straight on the floor. These exercises help to strengthen the iliotibial band and the surrounding muscles.

Ensure that your child wears appropriate shoes while running to prevent further damage to the iliotibial band.