Iliotibial band (ITB) syndrome causes pain on the outside of your knee. The ITB wraps closely over the bones in that area and ITB syndrome develops when that part of the the ITB experiences excessive compression against the bone. You can read more about all the reasons why ITB syndrome may develop in this blog post. That portion of the ITB will experience more compression if your leg moves in (adducts), knee turns in and pelvis drops excessively when your run. See the video below for a demo of what I mean.
There are several reasons why your leg may move in that way when you run. Weak glutes can for instance be part of the problem. But for some people it may be down to their running style. Interestingly, the research has shown that people can still have a poor running style even if they have strong muscles so you have to also retrain your running style to get your leg to move in a pattern that will place less strain on the ITB.
The components that we want to change or reduce when running include how much your:
knee turns in.
I demonstrate it in this video:
What cues may help to change your running style so that it doesn’t irritate your ITB?
1. If you find that you run with a cross over pattern (like you’re running on a tight rope), widen your stride a bit. How do you know if this is what you do? Signs that you’re crossing over when you run may include if you kick your ankles or, when filmed from behind, you can’t see a gap between your thighs.
2. Try to reduce your contact time with the ground, because it would give you less time to sink into each step – if this sounds weird watch the video for a demo of what I mean. You can do this through:
Increasing your cadence or step rate slightly
Thinking about landing softly
3. If you find that your knee turns in excessively while you run, the cues in point 2 may help but you can also reduce it by concentrating on keeping your knees pointing forward as you run.
Top tip for training while recovering from ITB syndrome
You should first allow your pain to settle to a 3/10 level before trying this as I find it doesn’t work for patients who have very irritated ITB's. My patients with ITB syndrome often find that they can do sprint training and stair running (only up NOT down) with minimal pain and without causing their injury to flare up.
I think the reason for this is that we naturally tend to have better form and a very high cadence (so less time for the leg to collapse in) when we run fast. You may find that these types of workouts can be a great way to maintain some of your running fitness while you recover and work on your running style. I would however suggest that you work with your physio to decide when you’re ready to start this, as you can make things worse if you try this too early in your rehab.