Iliotibial band Syndrome (ITBS) is a commonly occurring overuse injury of the knee. The condition most often involves pain in the region of the outside portion of the knee which occurs after repetitive motion of the knee. While ITBS is most common in sports requiring repetitive knee flexion (running, cycling, triathletes, etc.) it has also been reported in weightlifters, downhill skiers, soccer, tennis, and football players. Improper training is one of the most common causes of ITBS . Correcting these errors provides an easy way to help manage the pain. The following are five of the most common training errors that contribute to ITBS.
- Improper Shoes - Change your ratty old shoes! It has been shown that a sneaker loses 50% of its ability to absorb ground reactive forces after 300-500 miles. The more ware seen in a shoe, the more ground reactive forces are transferred to the knee.
- Running Hills - Downhill running is more likely to predispose an athlete to developing ITBS. The theory is that when running downhill the knee flexion angle at heel strike is reduced, which increases the amount of friction/irritation placed on the Iliotibial Band.
- Cambered Surfaces – One study found that running on cambered surfaces increased the incidence of ITBS. The theory suggests that the foot on the high side of the sloped road excessively rotates inward, thereby causing injury.
- Training Load - Increases in training load and inexperienced runners are also risk factors for injury. Specifically, one study has shown that weekly mileage was significantly greater and running experience was significantly less in the injured group. Also, in a study of 583 runners, increased mileage was an important predictor of injury.
- Pace - Improve your tempo. Biomechanical studies have shown that faster paced running is less likely to aggravate ITBS and faster strides are initially recommended over slower paced running.
Pain originating from the Iliotibial Band is often a limiting factor when training for a marathon or other long distance races. Correcting these common training errors along with a proper rehabilitative program has been shown to eliminate pain and allow you to perform at your best.
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