ITB Syndrome

Contributing Factors associated with ITB Syndrome

INTRINSIC FACTORS

– More common in males (most significantly men less than 34 years of age)

– Biomechanics (i.e., narrow step width, increased hip adduction in stance, increased step length, decreased lumbopelvic control)

– Decreased hip abductor strength

– Significant leg length discrepancy

EXTRINSIC FACTORS

– High training load

– Training incorporating significant downhill running

– Sudden increases in training load

Considerations in the management of ITB Syndrome

SHORT TERM

• Training load modification

Training load modifications often include a decrease in downhill hill running, speed work and or total volume. We need to maintain some training load, otherwise runners decondition and can experience repeated bouts of ITB related pain. In addition, when a runner de-conditions, they are at an increased risk of a ‘new’ injury. If symptoms are associated with a specific aspect of training load, it is best to reduce this first. 

• Soft tissue techniques/dry needling

Soft tissue techniques may assist with maintenance of tissue health.

LONG TERM 

• Gait retraining

If there are indications that you may be increasing ITB compressive loads as a result of your running technique, gait retraining may be beneficial. This is dependent on the outcome of a technique analysis. Gait retraining may involve increasing step width, increasing cadence and reducing hip adduction during stance. This assists in decreasing compressive load through the lateral knee.

• Load management

Graded return to training also allows the ITB to develop tolerance to cumulative loads experienced during running. Individuals may need to tailor their training to avoid excessive peaks in volume,  which place them at risk of developing ITB syndrome or other musculoskeletal conditions related to overload. 

• Strength training

Rehabilitation should target developing tolerance to peak loads and plyometric loads experienced during running. Tolerance to peak loads can be addressed via heavy resistance training, particularly through targeting gluteals and quadriceps. Plyometric exercises restore the body’s capacity for energy storage and release during running.