Iliotibial Band Syndrome (ITBS) is a common injury resulting from activities that involve repeated flexion and extension of the knee. ITBS is also called runner’s knee because it is common in distance runners. Although ITBS is an inflammatory condition which is not treatable by massage alone, massage may offer some pain relief by reducing tightness in the muscles that are connected to the iliotibial band.
ITBS causes pain felt on the outside of the knee. Pain anywhere else along the IT band is not ITBS. Onset is gradual, and, in many cases, pain is only felt during active, weight-bearing motion. The pain may go away after a period of rest but returns when the repetitive motion of the knee starts again.
If you have ITBS, running on sloped surfaces or downhill can be especially painful. Distance runners are prone to ITBS because they spend greater time in the weight-bearing phase of the running gait. Cyclists are also affected by ITBS due to the number of repetitions of repeated flexion and extension of the knee.
The iliotibial band is a strong, thick sheet of connective tissue that runs the entire length of the outside of the thigh. The gluteus maximus and tensor fasciae latae (TFL) muscles connect to the upper part of the IT band. The IT band is flat and wide for most of its length, narrowing to a cable-like structure that crosses over the lateral epicondyle of the femur and attaches to the upper part of the tibia.
The usual explanation for ITBS is that it is caused by inflammation as a result of continual rubbing of the cable-like section of the IT band on the lateral epicondyle of the femur as the knee is repeatedly flexed and extended.
Treatment for ITBS is usually concerned with reducing the mechanical cause of the irritation (Lowe W, Orthopedic Assessment in Massage Therapy, 2006). Rest, ice therapy, new shoes, gait modification, and stretches are often recommended. Many of these things are outside the scope of practice of a massage therapist. A massage therapist can, however, treat the muscles involved which may offer pain relief.
Ice, rest and gentle stretching to help ease tightness in the gluteus maximus and TFL muscles would be reasonable things to try. If you want to try self-massage concentrate on the muscles in the hip and buttocks that are connected to the IT band.
It is impossible to stretch the IT band itself. Tightness of the gluteus maximus and TFL can contribute to ITBS by pulling the IT band tight, increasing the friction with the femoral epicondyle. Working those muscles to relieve tightness may provide pain relief in some people by reducing the friction.
The glutes and upper thigh muscles should be part of every massage, especially for runners and cyclists. These muscles are important in every type of movement and regular massage can prevent them from becoming too tight and causing problems from ITBS to low back pain.
If you’re suffering from ITBS make an appointment with me to see if therapeutic sports massage will help ease your pain and get you back to performing your best.