The iliotibial band (ITB) is a fascia of fibrous and thick tissue that is found along the lateral part of the thigh.
The ITB originates from the fascia lata that is inserted above the hip and on the iliac crest, then continues downward, passing over the greater trochanter of the femur bone, (where some fibers join the gluteus medius and tensor muscles of the fascia lata,) continues its downward trajectory and is conform as the iliotibial band until it reaches the external femoral condyle; before inserting itself in the knee it passes over a protuberance called the lateral lateral epicondyle and continues its way crossing the knee until reaching a distal insertion in the tibia on Gerdy's tubercle.
The ITB injury is one of the most common causes of pain in the lateral external part of the knee with an incidence of 12% of the overuse injuries described in the runners.
This band suffers from conditions (iliotibial band syndrome) that cause an inflammatory friction injury, non-traumatic due to the constant excessive use of the knee that affects predominantly short and long distance runners and cyclists. This is generated by a continuous contact between the iliotibial band and the lateral epicondyle in the external and inferior region of the knee; and in most cases develops gradually as a result of intense training or performed excessively (often inadequately)
Symptoms of Iliotibial Band Syndrome
People with iliotibial band syndrome (ITBS) usually complain of 'throbbing' pain in the lateral part of the knee, sometimes with a burning sensation, which can be mild, moderate or very intense.
The lesion may be associated with signs of inflammation caused by movement of the iliotibial tract during flexion and extension of the knee.
Patients report that they are able to start a race without feeling pain, sometimes appearing symptoms when traveling very short distances. The clinical manifestations disappear with rest and reappear at the start of the next race.
If the symptoms of the Iliotibial band syndrome progress, then the pain may persist even during walking, particularly when the patient goes up and down stairs and occasionally it may extend along the entire path of the ITB.
The Ober test is the diagnostic maneuver normally used by doctors and physiotherapists to assess the existence of tension in the ITB.
It is not a problem that is due to a single cause, but several factors intervene.
Among the mechanisms of injury of the iliotibial band in the runners that bend and extend the knees in a repetitive and prolonged manner, the lateral epicondyle rubs against the iliotibial band producing friction, pain and inflammation.
That is, the iliotibial band is irritated by its sliding back and forth on the external femoral condyle.
Cyclists may suffer iliotibial band syndrome due to the position they hold on the bicycle.
Improper adaptation of the bicycle seat by placing it too far or backwards also causes the stretch to increase, forcing the extension.
An important element in ITB syndrome is the overload and excessive use of the knee, for this reason what happens in short and long distance runners and cyclists is generated by repetitive and prolonged stress in it.
Also important to note is the surface on which the person exercises; it is not uncommon to see excess running on inclined surfaces with many ups and downs.
Highly worn shoes are inadequate and cause pain, the more worn the shoe is, the more forces are transferred from the floor to the knee.