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"Mike's
approach to coaching really brings out the best in your
performance" Chris, Berkshire |
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 The
Iliotibial band (IT band) is a thick band of tissue
that extends from the thigh, down over the knee
and attaches to the tibia. When the knee bends (flexion)
and straightens (extension), the IT band slides
over the bony parts of the outer knee. The term
IT band friction syndrome (ITBFS) refers specifically
to a syndrome of lateral (outer side) knee pain
related to irritation and inflammation of the bottom
portion of the IT band.
As you run, flexion takes place at the hip and at
the knee. The IT band passes over the outside of
the knee and friction is produced. During weight
bearing activities such as running and walking,
compression and friction forces increase and pain
occurs. Also during weight bearing, there is a contraction
of the surrounding muscles which tightens the knee
joint. This leads to more friction over the outside
of the knee as the IT band crosses it and pain is
increased. If forces are increased the area will
become intensely inflamed and IT band friction syndrome
is produced.
 The
average jogger makes 3,000 foot strikes per mile.
That is 15,000 foot impacts for every five miles.
Each leg impact must bear the entire body weight
by itself-because in running you only have one foot
on the ground at a time. In walking, 30 percent
of the time, both feet are on the ground. The force
of landing is about three times your weight. that
means that if you weigh 75kg, the force when you
land is around 225kg. Shoe mileage should also be
considered. After 500 miles most shoes retain less
than 60% of their initial shock absorption capacity.
In runners with normal feet, the force of running
is dissipated by the foot. However, if you have
a minor abnormality in your foot setup, like high
or low arches, the force of the foot strike is passed
to the knee area. Biomechanical abnormalities associated
with the IT band syndrome such as supination in
the foot (rolling out when you foot strike) suggest
that the stress about the knee will increase and
possibly will cause more IT band friction. Common
predisposing factors include:
• Footwear - excessively worn on the lateral
heel and outside of the shoe
• The wrong shoe - 9 times out of 10 an individual
with runners knee are wearing a support shoe
• Leg length difference
• Runners with overpronation leading to increased
internal rotation of the knee and increased tension
to the outside of the leg.
• Running on Roads with a camber (side slope)
• Muscle Imbalance
• Foot dysfunction
• Low Back Issues
So What Can You Do?
Firstly, and most importantly the cause of the problem
must be addressed. In this case running posture
or footwear is probably the primary cause. However,
it would be worthwhile consulting with a therapist
who specialises in gait analysis and injury rehabilitation
to ascertain the exact causes.
To get the best advice, a full Running Gait Analysis
looking at footstrike, running technique, flexibility
and footwear would be of great benefit. This would
identify training faults, poor technique, inflexibility
and how functional and supportive your running shoes
are.
It maybe a case that the needs between the left
and right feet are significantly different, if this
is the true then several changes may need to be
made:
• To stabilise the foot and running posture
it may be advisable to have a custom orthotic made
to help to support the feet, legs and pelvis and
prevent the stresses of imbalance, weakness and
tightness. Custom orthotic can be of great benefit
not just for injury rehabilitation but for prevention
and performance as well.
• Assessment of the pelvis and lower back to
address any flexibility and strength Issues that
may be the cause of this asymmetry.
The Self-Help Guide
There are a lot of things that can be done that
will help to decrease the amount of muscular tension
that would contribute to the problems at the knee.
Flexibility: It is very important for the body to
have the same muscle length and tension on the left
and right sides of the body as well as to the front
and back. If there is a flexibility imbalance in
any of those combinations then a problem may arise
and contribute to further injury. In this case it
is essential that you stretch the tigher areas before
you do any strength training.
Stretching is the best thing that you can do immediately
(especially of the buttocks, IT band and Quadriceps.)
Self Help Action
• Rest and Ice - icing will decrease the amount
of inflammation present. This will help to settle
the problem and decrease the pain
• Stabilise the foot with well-fitted shoes
• Consider Custom Orthotics (Fitted by specialists)
buying an off the shelf product may not address
the imbalances as these come as the same prescription
left and right
• Avoid running on cambered roads
• Run on a variety of soft surfaces
• Avoid running down hill
• Stretching
• Carry out some strength work
• Consider changing discipline for a period
of time by cross training with other sports. If
you cycle, reduce the duration and cycle at a higher
cadence with a lower resistance. Try swimming, or
even deep water running with the aid of an aqua-jogger
belt
If you are in doubt about what to do, consult with
a specialist in your area or email info@drummondclinic.co.uk
to get more information or call us on 01628 639 532. |
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