Iliotibial band syndrome: one of the main causes of knee pain

Author: Chen Yin Shenzhen Traditional Chinese Medicine Hospital

Reviewer: Cao Xuemei, Chief Physician of Shenzhen Traditional Chinese Medicine Hospital

In our daily lives, we sometimes do long-term, high-intensity exercise, such as running, jumping, cycling, and going up and down stairs. These exercises have one thing in common: they require the knee joint to flex and extend repeatedly. If we do these exercises with improper strength and incorrect posture, or if we are born with genu varum ("O" type legs), flat feet, inversion of the feet, or imbalanced hip muscle strength, we will be prone to hip and knee pain after exercise, especially obvious pain on the outside of the knee joint. The knee joint will become swollen and stiff, and even make noises when flexing and extending. In severe cases, the movement will be restricted, affecting life.

Why is this happening? Because we suffer from a common sports system disease - iliotibial band syndrome (ITBS), which refers to inflammation and pain caused by overuse or injury of the iliotibial band (a connective tissue band extending from the outside of the hip to the outside of the knee joint), which mainly affects the flexion and extension of the knee joint.

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1. Self-examination of iliotibial band syndrome

Method 1: Pain will occur when you press directly on the outside of the knee joint.

Method 2: Lie flat and raise your legs, bend your knees downward, and pain will occur when you bend them 30°.

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II. Treatment of Iliotibial Band Syndrome

First of all, you should reduce the amount of exercise appropriately, pay attention to braking and rest, avoid painful exercises such as running and jumping, and give the damaged tissues sufficient rest and recovery time. In the acute phase, you can follow the RICE principle and brake (rest), ice, compress, and elevate the knee joint to reduce friction and pressure on the iliotibial band. After the acute phase (24 to 48 hours), you can apply hot compresses to relieve pain, and gently massage and stretch the iliotibial band to help relax tense muscles and fascia.

If the pain is severe and the knee joint is obviously restricted, seek medical attention in time. Conservative treatment is generally the first choice for iliotibial band syndrome. Physical therapy such as ultrasound and shock waves can be used to promote local blood circulation, accelerate the disappearance of inflammation, and relieve pain. Under the guidance of a doctor, you can take non-steroidal anti-inflammatory drugs, such as ibuprofen, nimesulide, etc., to relieve pain and reduce inflammation. You can also apply ointments such as Voltaren to the painful area to help relieve pain and swelling. When the pain is severe, a doctor can perform closed treatment: local closed injections at the painful point, such as procaine, lidocaine, and glucocorticoids, can quickly relieve pain and inflammation. In addition, an iliotibial band or knee brace can be used to reduce the pressure on the iliotibial band. For patients who are ineffective with conservative treatment and have severe symptoms, surgical treatment may be considered, such as bursectomy, iliotibial band release or lengthening, etc.

III. Recovery training for iliotibial band syndrome

After the acute phase, we can do some specific exercises to relieve symptoms and restore knee function by strengthening related muscle groups, relieving pressure on the iliotibial band, improving muscle imbalances, and increasing flexibility.

Strength training: Strength training to strengthen the buttocks and thigh muscles, such as hip extension, adduction, abduction, hip bridge, squat, etc., can help improve muscle imbalances and reduce pressure on the iliotibial band.

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Stretching training: Perform appropriate stretching training, such as knee flexion stretching, hip internal rotation stretching, etc., to increase the flexibility of the iliotibial band and reduce friction and pain.

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As the saying goes, prevention is better than cure. In order to prevent iliotibial band syndrome after exercise, we should pay attention to maintaining correct standing and sitting postures in daily life and avoid standing or sitting for long periods of time. We should arrange the amount of exercise reasonably, avoid long-term, high-intensity exercise, and pay attention to the combination of work and rest. Master the correct exercise techniques to reduce damage to the iliotibial band. We should strengthen muscle training in normal times, especially the training of the gluteus medius and the outer thigh muscles, to enhance their ability to support the knee joint. At the same time, we can choose suitable running shoes, insoles, etc. to reduce the impact on the knee joint during exercise.