Definition

Stress injury resulting from repetitive friction of the iliotibial band moving over the end of the femoral condyle when the knee is slightly bent (side of thigh bone where it articulates with the knee). Common in long distance runners, those who train on uneven ground.

Symptoms

Pain with recurring movements of the knee such as with stairs, increased pain after a change in running surfaces, and a rapid increase in mileage. The pain is hard to pin point but may be tender along the outside of the knee joint, possible swelling and crepitus. You may also feel a "snapping" as the ITB moves over the femoral condyle.

Causes

Increased mileage, improper footwear, tight ITB, increased "Q-angle," pronation of the foot, hill running

Treatment/Prevention

Activity modification to reduce the stress on the knee, such as decreasing mileage, changing running surfaces, and modifying footwear. Stretching of the ITB, cross-friction massage of tight ITB, strengthen hip abductors (glut max) which pull on the ITB when your foot is on the ground, modalities such as ultrasound to reduce inflammation.

• ITB stretch
• Step downs – to strengthen quadriceps muscle
• Monster walks – strengthen hip abductors such as gluts