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Location
The Iliotibial
band (ITB) is
a band of strong
tissue that
originates from
the outside
of the pelvis
and attaches
to the outer
part of the
knee. This is
why the player
will complain
of pain on the
outside of the
kneecap. Excessive
strain during
running can
cause shortening
of the tendon
which in turn
causes the tendon
to rub on the
knee. This friction
movement causes
the player pain.
This condition
may drastically
limit or even
completely stop
your training.
Symptoms
and Causes
Symptoms of
the iliotibial
band syndrome
(ITBS) include
pain or tenderness
on the outside
of the knee.
The pain may
start near the
end of a training
session.
An associated
condition to
ITBS is trochanteric
bursitis which
is basically
a sack of fluid
present at the
hip joint. As
the knee flexes
and extends
the iliotibial
band rubs. During
flexion and
extension of
the knee the
iliotibial band
rubs over the
femoral condyle
(two heads that
sit on top of
the iliotibial
band) which
leads to irritation.
Weak hip abductors
and gluteus
medius are often
a predisposing
factor.
The Gluteus
Medius muscle
is situated
at the top of
the buttocks
and its primary
function is
to raise both
legs out to
the side and
turning the
hip inwards.
The muscle prevents
the thigh from
buckling and
rotating forward
as the player
is running.
If the gluteus
medius is weak
the knee will
buckle which
will strain
the ITB.
The hip abductors
main function
is to abduct
the leg (push
it out towards
the side). If
these abductors
are weak the
ITB has to work
harder and can
get strained,
Other factors
to bear in consideration
is players with
bow legs, over
pronation and
leg length discrepancy.
Running in
circles also
places considerable
stress to the
ITB. Recent
studies have
shown that athletes
running in circles
have a higher
incidence of
ITBS. The angle
of force being
applied to the
ITB ismuch greater
and therefore
predisposes
the knee to
this injury.
.How
it affects Rugby
This is a classic
sign of over
training or
a over eager
rugby player
doing excessive
running including
hill work or
incline treadmill
running.
Treatment
of Illiotibial
Band Syndrome
Initial treatment
should consist
of an ice pack
which will reduce
inflammation.
Anti inflammatories
will help to
reduce the swelling.
Reducing training
intensity and
mileage work
is advised.
A deep tissue
massage is also
advised.
Other treatments
include:
- orthotics
will redistribute
pressure away
from the ITB
and address
any underlying
over pronation.
- The player
may need a
heel life
to address
a limb length
discrepancy.
- Regular
ITB Stretches,
view below.
- Wear a knee
strap to relieve
symptoms
- In some
severe cases
where rest
and ice fail
to settle
the symptoms
fully, then
a corticosteroid
injection
into the area
of the bursa
over the Lateral
Epicondyle
of the thigh
is usually
very effective.
- Strengthening
the hip abductors
and gluteus
medius muscles.
Illiotibial
Band Stretch
Sit with your
injured leg
bent and crossed
over your straightened
opposite leg.
Twist at your
waist away from
your injured
leg, and slowly
pull your injured
leg across your
chest. You should
feel the stretch
along the side
of your hip.
Hold the stretch
for 10 to 15
seconds. Repeat
the stretch
six to eight
times. This
stretching exercise
may be helpful
for Illiotibial
band syndrome
and adductor
strain.
We also recommend
the use of sports
orthotics/ insoles
to dramatically
speed up recovery
time. Knee supports
(view below)
provide compression
and stability
to the affected
muscle to increase
the healing
phase of the
injury.
 View
elasticated
knee support
Self-Treatment
Self treatment
for this problem
should include:
- Temporary
decrease in
training
- Side Stretching
- Shorten
your running
stride
- Use
orthotics
with arch
supports.
- Strengthen
your hip abductors
( gluteus
medius, etc.
)
Rugby
Rescue Recommends
Treat
the underlying
cause of Iliotibial
Band Sydrome
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