Thoughts from the journey… Excerpts from a day in the life of Sherry McLaughlin

22Oct/093

Iliotibial Band Friction Syndrome

Iliotibial band friction syndrome is often described as an overuse injury that produces pain on the lateral knee. In fact, it is listed among the Big Five of running injuries, along with Achilles tendonitis, chondromalacia, plantar fasciitis and shin splints.

Unfortunately, it is also often misunderstood.

For instance, the quick fix for this injury (and many of the others in the list) is simply to stop running for awhile. Just rest the area and let it recover. The premise is that running, in and of itself, created the problem.

But the question that really needs to be asked is, how come the other knee isn't hurting if both legs ran the same mileage? Is it simply a cause of overuse?

Yes and no. Running isn't bad for you. Bad running is bad for you.

The most common scenario that causes ITBFS is a limb that won't pronate. Under pronation. You won't see that too much in the literature.

The normal gait pattern is such that heel strike is designed to occur on the lateral (outside) of your heel with pronation occurring for 25% of the stance phase. This act of pronation not only acts as a shock absorbing mechanism, but also transfers the force to the thicker and larger structures of the medial knee.

Someone so spends more than 25% of stance phase in supination is going to make the ITB very angry. After all, it isn't designed to have to cushion the blow of force dissipation for such a long time.

Some common causes of a limb not pronating?

• Tight gluteus medius (lateral hip muscle) - See the photo? Can you do this move equally on both sides?

• A leg that feels too short (pelvic malalignment, quadratus lumborum or iliopsoas trigger points)

• A subtalar joint that won't evert (Is there a history of ankle sprains in the past?)

• A tight lateral hamstring (Does the revolving triangle in yoga class make you fall over?!?)

• And... a shoe that offers too much support (Check to see if there is a gray bar on the medial side of your shoe last!) We are fans of neutral shoes for these folks.

The good news is... it's fixable! And it doesn't require tons of time away from running.

Oh, and by the way... if you understood what I just said, then you will realize that the ITB is overworked and overstretched in this scenario. Why on earth would you want to stretch an already over stretched muscle?

If you have this problem, or know of someone who does... do them a favor and look up at the hip and down at the subtalar joint. Fix that stuff and then send them back out on the road.

Until next time...