By Joshua Dubin, D.C., C.C.S.P.
Running has increased in popularity for cardiovascular fitness and sport over the last decade (1,2,3,4). It has been estimated that approximately 30 million Americans run for exercise (5). However, it has also been projected that one-half to two-thirds of those runners may sustain a non-traumatic repetitive strain injury at least once (5,6). Iliotibial band friction syndrome (ITBFS) is an inflammatory, repetitive strain injury to the knee that is particularly common in long distance runners (1,7,8,9,10). ITBFS may be caused by a multitude of factors including training errors, worn out running shoes, and/or lower leg misalignments (1,4,11,12,13,14,15,16). The main symptom of ITBFS is a sharp pain on the outer aspect of the knee that can radiate into the outer thigh or calf (17,18,19). Knee pain usually occurs at a particular distance of each training run, probably due to muscle fatigue (1,12), and is more pronounced shortly after the foot contacts the ground surface (20). Attempting to run throughout the pain will intensify the symptoms, eventually causing the athlete to shorten his stride or walk. The frustrated athlete, who may be training for a race, will not be able to progress his mileage appropriately. However, the despondent runner may be unreceptive to advice to temporarily discontinue running and initiate therapy, resulting in a more severe grade of injury. Pain may now be present with walking, exacerbated by walking up or down stairs, and a stiff-legged gait may be acquired to relieve symptoms (21). Based on clinical experience and as a recreational runner, I have identified several reasons why most athletes are unwilling to temporarily discontinue running: it is a time-efficient exercise; genuine friendships are formed in group training; no other cardiovascular exercise can beat the “runner’s high”; and the fear of not attaining his or her training goal. My experience and research studies show conservative therapy to be extremely successful in the treatment of ITBFS (8,22). A proper treatment protocol should include the following: inflammation reduction, pain-free training modification, flexibility and endurance strength training of the muscles surrounding the pelvis and thigh, and correction of faulty training habits (1,2,7,8,9,10,11,12,13,23,24). Read the full article here…ITB Friction Syndrome