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Q:
How long does it take to heal from iliotibial band syndrome? What can I do to help the rehabilitation?
Answered by
David Golden M.D.
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A:
Healing time is variable. Avoiding inciting activities and stretching the iliotibial band (ITB) is key in the rehabilitation process. The syndrome is caused when the thick fascia of the ITB rubs on the femur (thigh) bone. It often affects cyclists or runners. A visit to a physical therapist to show you the proper exercises is helpful. Most of the exercises can be done at home. A four-to-six week course of therapy is often sufficient time to allow return to activities. Rarely, if the pain is not responsive to therapy, surgery may be recommended.
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Q:
I have been running for close to 20 years and typically do 15-20 miles a week. While training for the Boston Marathon, I started getting severe pain in the sides of my knees starting at high mileage (about eight to ten miles). The doctor told me it was an IT band problem and sent me to six weeks of physical therapy. I cut way back on training and took high doses of NSAIDs for the race. I made it through the marathon in pain, walking at times to relieve the irritation. I tried icing, stretching, and not running, but it did not improve. The pain starts at lower mileage now. I can’t run more than three or four miles without pain. Everyone I know with this problem says it goes away. What am I doing wrong? How do I get over this problem so that I can get back to running?
Answered by
David Golden M.D.
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A:
You may not be doing anything wrong. Often, a committed runner like yourself is very intent on returning to running without pain and will follow all directions explicitly. Sometimes, the condition can be refractory to therapy. In ITB syndrome, non-steroidal anti-inflammatory medications are not often as helpful as in other orthopedic conditions. It is possible that surgery may be needed to remove the part of the fascia that is rubbing on the distal part of the femur (the lateral condyle). Talk to your doctor about the risks and benefits of surgery.
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Q:
When I run, there is a tightening in my knee on the outside and to the back of the middle of my left knee. It feels like a piece of rubber is tightening in my knee and it becomes painful. This symptom only occurs when my foot lands and pushes off and at the full rear extension of my leg. It does not hurt to walk on and I rarely feel any other knee discomfort. I am 30 years old and have been running seven miles a day for about two years and have tried stretching and icing my knee to no avail. What do you think this is?
Answered by
David Golden M.D.
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A:
It is always difficult to make a diagnosis without a detailed history and physical exam. One possibility is iliotibial band friction syndrome. The lateral side of the thigh has a very thick facial (tough tissue) band that runs from the hip to the lateral aspect of the knee. In runners and cyclists, this band rubs against the distal part of the femur (thigh bone) and causes pain with activity. A visit to your doctor can confirm the diagnosis. Treatment is aimed at avoiding inciting activity and stretching exercises.
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Q:
My doctor recently told me that I have Iliotibial Band Syndrome. He recommends that I stop running. Will I ever be able to run again?
Answered by
David Golden M.D.
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A:
Very often, after four-to-six weeks of therapy for ITB syndrome, slow resolution of activities is allowed. Most of the time, the condition is limited in time and running can be resumed. Modifying your activity to avoid pain is key. Talk to your doctor about the time during which running should be avoided.
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Q:
Are there any surgical treatments to repair Iliotibial Band Syndrome?
Answered by
David Golden M.D.
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A:
Rarely, when ITB syndrome is not responsive to non-operative therapy, surgery may be recommended. The surgery removes the small portion of the iliotibial band that is rubbing on the distal aspect of the knee (the femoral condyle). Removing the part of the tight fascia removes the insult and alleviates the pain. Talk to your doctor about the risks and benefits of surgery.
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