ITBFS presents as lateral knee pain and accounts for 24% of cycling injuries every year. It is also common in long distance runners due to overuse and repeated flexion and extension of the knee. ITBFS is associated with local swelling and tenderness which does not settle with ongoing activity; it usually results in weakness and fatigue of hip abductors, knee flexors and extensors.
The ITB is a band of thick fascia which runs down the lateral aspect of the thigh, enveloping gluteus maximus and tensor fascia latae. It inserts along the length of the femur, passing across the lateral femoral epicondyle and attaching to the patella and tibia.
ITBFS can be caused by training errors and poor technique, resulting in biomechanical abnormalities and muscle imbalance; however, ITBFS can often be mistaken for patella femoral syndrome, biceps femoris tendinopathy or injury to the superior tibiofibular joint.
At Jonathan Clark Physiotherapy, our therapists provide special tests to diagnose ITBFS, e.g. Ober’s Test, which if positive, provokes tightness and sometimes a burning sensation due to shortening of the tensor fascia latae or gluteal muscles, causing increased load to the ITB. We also provide education and advice to reduce pain and inflammation.
Our treatments aim to help correct foot and hip biomechanics, this includes activity modification and exercise programmes to increase stability of the hip, as well as to strengthen hip external rotators and abductors.
We also provide soft tissue massage, acupuncture, trigger point release, taping and specific stretches and exercises to reduce muscle tension and tone, all of which provide an offloading effect on the ITB whilst activating weaker muscle groups.