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Iliotibial Band Syndrome (I.T.B.)

I.T.B. SyndromeThe pain that is experienced with this condition is located on the outer aspect of the knee. It is not a pain felt within the joint, as it does not affect the knee joint itself. If you flex the knee about 30 degrees and experience pain when you apply pressure to the outside of the knee with your fingers, you may have Iliotibial Band Syndrome. Another test for this problem is: if walking stiff-legged (not bending the knee) produces no pain, but walking normally (bending the knee) does produce pain, then you may have Iliotibial Band Syndrome.

What is Iliotibial Band Syndrome (I.T.B.)? The I.T.B. is a thickened strip of fascia or muscle cover. It begins as a thick band that covers the outer thigh muscles, and travels down the outside of the leg to the knee joint, where it attaches to the outer edge of both the tibia and fibula, just below the knee joint. In so doing, the I.T.B. must lie against the protruding outer edge of the femur, just above the knee joint. As the knee is flexed and extended, the I.T.B. rubs against a thin fluid filled sac (a Bursa), between it and the femur. The bursa acts to reduce friction, and to protect the I.T.B.. When the Bursa does not function properly, or there is a change in your running or cycling pattern, or a biomechanical foot or leg problem begins to act up, the I.T.B. becomes inflamed and painful.

I.T.B. SyndromeBiomechanics: As an athlete runs or pedals a bicycle, flexion and extension takes place at the knee. When the knee is flexed 30 degrees or more, the I.T.B. passes over the outer protruding edge of the femur, shifting posteriorly behind the edge of the femur. As the knee is extended, the I.T.B. passes back over the edge of the femur, and shifts anteriorly in front of the femur. It is this motion that commonly leads to irritation and pain of the I.T.B. and its protective bursa. If a biomechanical defect is present, such as bow legs or pronation in the feet, the I.T.B. rubs against the edge of the femur with more force, causing greater irritation and pain.

Causes of Iliotibial Band Syndrome: Although the onset of this condition has been linked to athletic maltraining, such as an increase in running or cycling distances or running on a pitched surface, research has shown that in most cases of I.T.B. Syndrome, a foot or leg biomechanical abnormality is also present. The most common of these abnormalities found in the athletes suffering from this condition are:

1. pronation of the foot is the number one abnormality linked to I.T.B. Syndrome. Pronation is a turning out of the foot at the ankle, so that one has a tendency to walk on the inner border of the foot. When the foot turns out the tibia is forced to rotate internally (inward) and tightens the I.T.B., causing it to rub with more force against the edge of the femur. This eventually produces inflammation and pain.

2. high or low arches prevent the arches in the feet from acting as the natural "shock absorbers" they were designed to be. Thus, the force of each foot strike (up to 3 times the body's weight) is passed on to the knee area. When this occurs the soft tissue structures surrounding the knee tighten, causing the I.T.B. to rub with more force against the edge of the femur, eventually producing pain.

3. short leg syndrome causes the foot on the short leg to excessively plantar flex (the foot and toes are pointed down) inorder to "reach" the ground. This pulls on the muscles and soft tissues in the outer aspect of the leg, causing the I.T.B. to tighten against the femur. When this occurs there is excessive rubbing, friction, and pain.

4. bow-legs also cause tightening of the soft tissues on the outer aspect of the leg and knee, forcing the I.T.B. to rub with greater force against the edge of the femur. This will eventually produce inflammation and pain.

Self-Treatments: These steps will help to provide you with short term pain relief:

1. In order for healing to occur, the abnormal movements of the I.T.B. against the outer edge of the femur must be eliminated. This is best accomplished with the use of our I.T.B. Strap. This unique Strap applies mild and comfortable compression at the site of discomfort. This compression will help to eliminate the friction and painful movements of the I.T.B. Our I.T.B. Strap is not only effective in the treatment of I.T.B. Syndrome, but it is also used by doctors and therapists to help prevent reoccurrences of this problem! For more information about this uniquely effective strap, click here.

2. Reduction of weekly training sessions by at least one half. During these sessions, also reduce your mileage by one half.

3. Shorten your stride.

4. Running and cycling must be done on flat surfaces; avoid pitched and circular tracks.

5. Frequent applications of ice packs to the outer aspect of the knee. (Chemical ice packs or bags of frozen peas, held loosely in place with an Ace Bandage works well). If the cold becomes uncomfortable, remove the ice pack immediately.

I.T.B. Syndrome6. Stretch the I.T.B. by doing side stretching exercises. While standing and holding on to a chair, place the injured leg behind the painfree leg. (If the right leg is painful, place it behind the left leg). With both feet planted firmly on the ground, lean away from your right side, toward your left side (do not rotate your body, just lean). You may, or may not, feel a pull on the I.T.B; either way is o.k., so be careful not to over-stretch. Hold this position for 10 seconds. Rest, and repeat 10 times. If the pain increases, stop immediately.

The following combination of remedies will help provide you with long term pain relief:

1. In order to obtain long term relief from I.T.B. Syndrome you must control the biomechanical abnormalities of the legs and feet which cause the I.T.B. to rub against the outer aspect of the femur with excessive force. Unless these problems are quickly and properly overcome, the I.T.B. pain may not completely subside, or if it does, it will usually return when normal running and cycling are begun again. To treat these abnormalities, you must stabilize the feet; provide proper shock absorption in the foot, so that abnormal forces are absorbed in the foot, and not passed on to the knee; and, control limb shortages and bow legs. Custom-Made Sports Orthotics: in my 30 years of private practice experience, I have found that the only way to effectively treat these problems, and help to eliminate I.T.B. Syndrome, is with the use of custom-made sports orthotics, designed for this condition by our award winning affliate OurFootDoctor.com.

2. Along with the stabilization that our custom-made orthotics provide, direct support of the I.T.B. is needed to "give you the edge" in preventing the return of I.T.B. Syndrome. Our I.T.B. Strap applies mild compression to the I.T.B. above the knee, thus eliminating abnormal rubbing against the femur. When this occurs, the friction and inflammation that produces I.T.B. Syndrome will not return!

Custom-Made Orthotics for Iliotibial Band Syndrome:

The advanced technology that is employed in our custom-made orthotics enables them to gently hold the feet in their neutral or normal position, thus overcoming the biomechanical defects of the feet and legs (such as pronation and bow legs), that lead to I.T.B. Syndrome. This allows the feet to function as the efficient and stable foundation that our bodies need; thus the Iliotibial Band, the knee, hip, and back are not subjected to abnormal stresses, and they function in their proper alignment. This reduces fatigue and pain throughout the entire body, not only the knee.

Our orthotics will also provide semi-flexible support to the arch by "giving" to absorb the shock of each step, rather than our foot and knee (the orthotic acts in the same way that a shock absorber does on an automobile). When our weight is removed from the orthotic, the arch returns to its original height since the material we use has a built-in "memory."

Shortages in one leg are easily addressed by adding the proper lift to the orthotic for the short leg. And by providing increased padding and support for the balls of the feet using materials that mimic the action of our body's own fatty pads, these orthotics will not only provide comfort, but will also help to prevent stress fractures, joint pain, and callus pain.

Order a pair of our Custom-Made Sports Orthotics for Iliotibial Band Syndrome here, or see our special promotion below.

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I.T.B. Strap:

Our extremely effective I.T.B. Strap will apply compression at the area of discomfort to help relieve Iliotibial Band Syndrome. The strap uses compression to help prevent the snapping or friction of the Iliotibial Band over the bony prominence just above and outside of the knee joint or further up the leg at the hip joint allowing the healing process to begin. This I.T.B. Strap is recognized as one of the most effective treatments for Iliotibial Band Syndrome. As such, while it may alleviate the symptoms of Iliotibial Band Syndrome, the cause of the affliction may still be present. Ideally, the user should wear the strap nearest the area of most discomfort. However, it can be worn approximately 2" - 3" in either direction with beneficial results. If you are not sure of the extent of your problem, then see your doctor.

Warning: Wear tight enough to attain relief but not impede circulation and normal leg movement. Do not wear to bed.

Note: If you are between sizes, the manufacturer suggests you order the smaller size.

Order an I.T.B. Strap here, or see our special promotion below.

To determine your size: Measure circumference at the site of your most discomfort. (Universal right and left.):


$16.90 each

Special Promotion:

Order one pair of our Custom-Made Orthotics for
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To determine your size: Measure circumference at the
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