In years of working with athletes at various levels one of the most common injuries seen would have to be Ilio-tibial band (ITB) syndrome, which is generally characterised by pain down the outside of one or both legs, between the hip and the knee.
Firstly at bit anatomy, the ITB is essentially an extension of the Tensor Fasciae Lata muscle, which attaches from the crest of the ilium to the outside of the knee, and functions to control hip movement and stabilise the outside of the knee.
It stands to reason then that any abnormalities of joint function in the lower limb will have an effect on the ITB, and why it is most commonly seen in runners, cyclists or hikers/trampers. The most common symptoms associated with ITB syndrome include:
Sharp or burning pain that can start anywhere from the hip to just above the outer part of the knee.
Pain that worsens with running or other repetitive activities.
Swelling over the outside of the knee.
Pain during early knee bending.
Generally a gradual onset of symptoms.
The next statement I will make is, SO WHAT. For me what is more important is the question WHY?
If it was the action of running that caused the problem then everyone would have ITB syndrome, would they not?
There are numerous muscular/soft tissue causes that are bandied about, ranging from weak hip/glutes, weak quadriceps and weak core muscles, which may be true, but why are they weak if you’re running?
There are the more obvious potential causes, such as: worn out or broken down shoes, sudden sharp increases in mileage, poor control running downhill.
As can be seen in the picture on the right, not only are the shoes worn out, but worn asymmetrically when comparing right to left. Again the question is why, because they should wear evenly.
Then there is having a look at the underlying biomechanics of what your feet, knees, and hips do through the gait cycle, and in particular your feet. If your feet pronate (arches collapse), it sets up the altered biomechanical functioning of your entire lower limb and spine, the details of this I won’t go into too much. What I contend is that it is the poor functioning of the feet that then affect everything else and cause the symptoms of ITB syndrome, as well as the above-mentioned weak/tight muscles that people tend to focus on.
What you are probably asking yourself right now is all ITB syndrome caused by my feet, maybe not, but if you’ve had recurring episodes of it, or you’ve been having longstanding treatment without much success, then perhaps it’s time to look elsewhere and have someone look at your feet.
If you are interested in tackling your knee or hip pain, and looking for an alternative give us a call and book an appointment where we can chat about what you are going through, and come up with an effective multidisciplinary approach to getting you not only pain-free, but well again.