Your knee has been hurting for a while and there is swelling and pain especially on the outer portion of the knee. You tell the doctor that the pain is especially intense when you are going down stairs, there is a popping/snapping sound whenever you bend your knee, even when you are getting out of the car you hear this sound, and it is painful. This is the classic presentation of Iliotibial Band Syndrome. Iliotibial Band Syndrome is one of the leading causes of knee pain.
The iliotibial band is a thick fibrous tissue called fascia. This band functions to provide support to the gluteal and thigh muscles. The iliotibial band attaches to the tibia bone, which is just below the knee, as well as the hip. Since the iliotibial band is attached to the hip as well, there may also be hip pain, but knee pain is more common. Iliotibial Band Syndrome can be caused by various sports/training workouts. Some examples are:
- Most common in runners-especially those who run on a banked surface and always run in the same direction
- Racquet ball/tennis
- Weight lifting-especially squatting due to the increased knee flexion plus the addition of heavy weights
- Cross country-especially running down hills
- Increased length of workout sessions
- Sitting for long periods of time
Iliotibial Band Syndrome may also be due to poor biomechanics while participating in these sports. Biomechanics is the way the foot, ankle, leg, knee, thigh, and hip all function together during gait. If one aspect is mal-aligned, this will lead to problems, such as straining the iliotibial band, which will lead to Iliotibial Band Syndrome.
Iliotibial Band Syndrome makes up 12% of running injuries. The following are specific symptoms of Iliotibial Band Syndrome:
- Swelling on the outside of the knee
- Pain with each step when the heel hits the ground
- Stinging/burning sensation above the knee
- Clicking sound when bending the knee
- Difficulty with stairs
- Feeling of tightness
There is treatment for Iliotibial Band Syndrome; however, it is not an instant fix. First, the inflammation needs to be controlled and diminished. Ways to reduce the inflammation are:
- Rest, ice (knee and hip), compression (ace wrap), and elevation of the leg
- Take a non-steroidal anti-inflammatory medication, such as Ibuprofen
It will take a few days to get rid of the inflammation. With getting rid of the inflammation, your knee may feel better, but do not go back to your normal work out routine. For a couple weeks, it would be beneficial to focus on stretching. The iliotibial band can be stretched by lying on your side and putting a foam roller under your hip. Once the foam roller is in place roll back and forth from the top of your hip to your knee to completely stretch the iliotibial band. Do this stretch on each side for 60 seconds-2-3 times per day. Your first time doing this stretch may be painful due to the tightness of the ilitiotibial band, so begin the rolling by keeping the foot on the ground to remove some of the weight off the foam roller. After doing this stretch for few days, more weight should be able to be applied to the roller, so lift your foot off the ground to apply more weight. In addition to this stretch, also do your normal routine stretches to help maintain flexibility.
If reducing the inflammation and stretching is not effective, a consult with a physical therapist may be needed. Podiatrists can also help in treating Iliotibial Band Syndrome, since the underlying cause may be due to poor biomechanics while performing your sport/workout. A podiatrist can improve your biomechanics by prescribing orthoses.