If you’re feeling some pain on the outer aspect of the knee then you may be feeling the affects of Iliotibial Band Syndrome (I.T.B.). It doesn’t affect the knee joint so you won’t feel the pain inside your knee. You can perform a quick test you can do to see if you have this syndrome. You need to apply pressure to the outside of the knee when you’ve got it bent at a 30 degree angle to test yourself. A walking test is reliable too. If you walk with your legs stiff and you have no pain but walking normally is painful then that’s a good indication that you are experiencing this syndrome. The stiff legged walking test means that you don’t bend you knees.
When diagnosed it means that there is a thickened strip of muscle cover (fascia). It starts in the upper leg as a thick cover over the outer thigh muscles, expanding down the leg until it gets to the knee joint. There it attaches to the outer edge of the tibia and fibula, in the area just below the knee joint. The femur is involved too. There is a sac full of fluid known as a bursa that is rubbed against by the I.T.B. When the I.T.B. becomes inflamed because of this rubbing that occurs for one of several reasons, then it becomes painful. This means the bursa isn’t working correctly, or there is a biomechanical foot or leg problem that starts causing issues.
In order to understand the biomechanical issues there would be a full discussion of the actual workings of the knee and leg muscles with its structure. It would be best if a cutout model could be viewed so you can see the various parts of the leg functioning. Some specific conditions (defects) such as bow legs or pronation in the feet can be the particular biomechanical defect that spurs the irritation and resulting pain.
What seems to kick this off is sometimes attributed to some athletic activity that stresses a leg or knee like a change in the running or cycling activities (doing them longer than usual, or on a steeper incline for example) but in most cases a biomechanical abnormality was also found. These can be the pronation or bow legs mentioned earlier or high or low arches or a short leg syndrome.
There are some shorter term actions that can reduce the pain felt with I.T.B. Syndrome.
Suggested are:
Cut the number and length of training sessions in half;
Exercise on flat surfaces, particularly for your running and cycling;
Use ice packs frequently on the outer areas of the knee (chemical ice packs or other types of frozen items inside a loose ace bandage works well);
Stretch the I.T.B. by performing some specific sideways stretches; and
Protect the I.T.B. with a special strap.
Long-term solutions to reduce pain involve controlling the biomechanical defects or using custom-made orthonics, employing some high-tech sports orthonics.
As always, seek the advice of a doctor who will probably refer you to a specialist.
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