How cross country runners can avoid ITBS and debilitating knee pain

Cross country runners are hitting the trails this time of year but a common painful injury can bring them to a sudden stop. As an athletic trainer at Cincinnati Children’s, I see an increase in patients in the fall with Iliotibial Band Syndrome (ITBS), an injury to the IT Band.

The iliotibial band (IT band) is a “band” of tissue that runs from the top of the hips down the outside of the thigh, crossing the outside of the knee. It attaches to the shin bone and helps stabilize and move the knee joint. It serves as a connection between many of the major hip muscles and the knee.

ITBS most commonly occurs on the outside of the knee. ITBS begins with tightness within the IT band. After time, this tightness creates a ‘friction syndrome’ where the IT band courses over the outside of the thigh bone nearest to the knee. Movement of the knee increases the fiction there, which causes pain. IT band pain can be severe, lasting for weeks or months.

Symptoms and Causes of ITBS

The most frequent symptoms of ITBS are typically swelling and pain on the outside of the knee – over a portion of the thigh bone called the lateral femoral condyle. Pain is often exacerbated by going up and down stairs, stepping out of a car, and walking or running up and down inclines.

ITBS can result from activities that cause the leg to turn inward repeatedly. This can include wearing worn-out shoes, running downhill or on banked surfaces, running too many track workouts in the same direction, or simply running too many miles.

Treatment of ITBS

Once ITBS is diagnosed, athletes will often need to enter into a period of decreased participation (running fewer miles) or complete rest (no running at all). Anti-inflammatory medication (for example, ibuprofen or naproxen) and ice are helpful with recovery. In the majority of runners, rest and medications will improve pain. Cross-training with activities like swimming, cycling, or pool-running can be extremely helpful to maintain strength, balance, and continue exercise while resting from running. Many individuals will require the assistance of a trained physical therapist to improve ITBS. Here at Cincinnati Children’s Hospital, we have the ability to examine runners in a comprehensive Runner’s Clinic, where we use multiple cameras (both in 2D and 3D) to evaluate running mechanics and potential risks for ITBS.

Prevention of ITBS

  • Decrease your mileage or take a few days off if you feel pain on the outside of your knee.
  • Walk a quarter- to half-mile before you start your runs.
  • Make sure your shoes aren't worn along the outside of the sole. If they are, replace them.
  • Run on softer surfaces, such as grass or gravel

At Cincinnati Children’s Hospital, we are very invested in getting your athlete back to their sport and keeping them healthy and strong while they compete. If you or your athlete has any questions, please call us at (513) 803-HURT.

Rebecca Connolly Follow

Rebecca Connolly is an athletic trainer in the Division of Sports Medicine at Cincinnat... View Full Bio

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