The ITB or iliotibial band is a broad strap-like structure the runs down the outside of the thigh. It connects your hip to your knee and works hard in activities such as running and cycling. It can become chronically overloaded due to various factors relating to foot and hip alignment. Pain is usually felt in the lower part of the band where it connects to the knee but it can occur further up as well.
Ciaran is in his late-twenties and works in IT. He has played various sports over the years but now keeps fit mainly by road running averaging 30km a week spread over 3 sessions. Over the past few months he has noticed a gradual build- up of stiffness and pain along the outside of his right thigh and knee. A friend had shown him how to use a foam roller to massage his ITB but this only gave temporary relief. By the time he visited Stranmillis Physiotherapy he was having a lot of pain and stiffness when standing up after sitting at his desk for a while. He said that he felt like an “old man”. He had stopped running at this stage but the pain and stiffness was still there and were making walking difficult. On assessment Ciaran had over-development of his lateral thigh muscles [lateral quads] and hamstrings and under-development of his gluteal muscles (gluts) He also had a problem with the alignment of his right hip. All these factors combined to create excessive load on his ITB’s on both sides with the right side being worse due to the hip problem. Treatment was directed at correcting the muscle imbalance at the hip and pelvis using myofascial release techniques and trigger point work. Exercises focused on hip and pelvic control. Ciaran’s pain settled gradually over 3 sessions. As his pelvic control improved running was gradually re-introduced. Ciaran had 5 treatments and was able to gradually get back to his previous level within 2 months. He was advised on simple maintenance exercises to keep his gluts functioning properly.