Iliotibial band syndrome, or Iliotibial band friction syndrome as it is also called, is one of the most frequent overuse knee problems in athletes. Especially runners and cyclists suffer from this problem.
In my earlier post knee pain it band syndrome treatment prevention I described what ITBS is, how to treat it and how to prevent it. In 8 yoga poses for removing or preventing knee pain it band I showed some Yoga postures that work good if you are suffering from Iliotibial band syndrome.
In this post I direct you to a few products that can help you to recover and prevent IT band problems. I hope to be able to help you with these posts and those product directions. If you have any other suggestions or information, please tell me and I will include this information in the blog as well.

Here is a list of some books that I find useful for getting more information about ITBS. There are also some books that help preventing it.

DVD:

Other products:

As a triathlete, runner or cyclist you probably know somebody with knee pain. Knee problems are very common in this group of people and the leading knee problem is the Iliotibial band syndrome (ITB) or Iliotibial band friction syndrome as it is also called. Typically people suffering from ITB are feeling a diffuse pain in the knee. Sometimes there is also a painful, sharp localized discomfort nearby the knee joint.

The Iliotibial band is a tough band of tissue running along the thigh bone. It starts at the hip and ends on the shinbone, shortly beneath the knee joint. Until recently it was believed that by flexing and extending the leg, the IT band was rubbing against the thigh bone, nearby the knee joint. This rubbing would cause friction and the friction would make the Iliotibial band sore. This soreness would be the cause of the pain.
Recently, researcher have found out that the IT band is not rubbing at all (Fairclough et al.). The cause for the pain is rather due to a pressure from the IT band on a fatty tissue. This fatty tissue is placed between the IT band and the knee joint and in this tissue there are a lot of nerves, which when stressed will give you a feeling of pain. The pressure coming from the IT band is build up through flexing and extending the leg.
With this new understanding of the biomechanics of the Iliotibial band syndrome it has become clear that to reduce the tension on the Iliotibial band you have to reduce the tension in the muscles connecting to it. That is primarily the gluteus maximus, the biggest muscle of the buttocks, and the tensor fasciae latae which is a muscle of the thigh.
You can reduce the tension through stretching and strengthening them. The stretching exercises I proposed in my last post 8 Yoga poses for removing or preventing knee pain (IT band) could help you with that.

Typical symptoms of Iliotibial band syndrome are:

• Pain just above the knee joint
• Swelling or thickening of the IT band over the lateral femoral epicondyle
• Pain at the hip (mostly elderly and pregnant)
• Diffuse pain in knee area
• Painful, sharp localized discomfort at the lateral femoral epicondyle
• Clicking – it feels as if the IT band tightens and snaps across the joint

Typical causes for IT band syndrome are:

• Increasing distance too quickly
• Excessive downhill running
• Cycling with the feet toed-in to an excessive angle
• Running on a crowned surface
• Uneven leg length
• Bowlegs
• Weak hip abductor muscles

Typical treatment of ITBS are (non-surgical):

• Putting ice on the sore spot
• Stretching
• Massage
• Rest
• Hip abductor strengthening

For those of you who haven’t got a problem with the IT band, the following methods could help preventing it:

• Stretching (ITB, quadriceps, hamstrings and gluteal muscles)
• Strengthening of quadriceps, hamstrings, calf muscles and hip abductors
• Gradually increasing training volume
• Avoid running downhill
• Rest
• Shorten your stride
• Using a correct sit position on the bike

If you want to prevent, cure or get a better understanding of ITBS, you might want to take a look the following products that I have put together for you: Products aimed at ITBS.
References:

Cosca DD, et al.; Common problems in endurance athletes; Am Fam Physician. 2007 Jul 15;76(2):237-44
Devan MR, et al.; A prospective study of overuse knee injuries among female athletes with muscle imbalances and structural abnormalities; J Athl Train. 2004 Jul-Sep; 39(3): 263-267
Ellis R, et al.; Iliotibial band friction syndrome — a systematic review; Man Ther. 2007 Aug;12(3):200-8
Fairclough J, et al.;Is iliotibial band syndrome really a friction syndrome?; J Sci Med Sport. 2007 Apr;10(2):74-6
Fairclough J, et al.; The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome; J Anat. 2006 Mar;208(3):309-16
Farrell KC, et al.; Force and repetition in cycling: possible implications for iliotibial band friction syndrome; Knee. 2003 Mar;10(1):103-9
Fredericson M, et al.;Practical management of iliotibial band friction syndrome in runners; Clin J Sport Med. 2006 May;16(3):261-8
Fredricson M, et al.; Iliotibial band syndrome in runners: innovations in treatment; Sports Med. 2005;35(5):451-9
Grau S, et al.; Hip abductor weakness is not the cause for iliotibial band syndrome; Int J Sports Med. 2008 Jul;29(7):579-83
Hamill J, et al.; A prospective study of iliotibial band strain in runners; Clin Biomech (Bristol, Avon). 2008 Oct;23(8):1018-25
Khaund R, et al.; Iliotibial band syndrome: a common source of knee pain; Am Fam Physician. 2005 Apr 15;71(8):1545-50
Miller RH, et al.; Lower extremity mechanics of iliotibial band syndrome during an exhaustive run; Gait Posture. 2007 Sep;26(3):407-13
Paluska SA; An overview of hip injuries in running; Sports Med. 2005;35(11):991-1014
Tibor LM, et al.; Differential diagnosis of pain around the hip joint; Arthroscopy. 2008 Dec;24(12):1407-21
Wanich T, et al.; Cycling injuries of the lower extremity; J Am Acad Orthop Surg. 2007 Dec;15(12):748-56

One of the most common knee problems by athletes is the Iliotibial band syndrome, also known as IT-Band syndrome. This is a well known complication by runners and cyclists. The IT-Band is a thick band of tissues running from the pelvis, along the hip, down the outside of the thigh, around the outside of the knee, and to the tibia. If you have this problem you will feel pain on the outside of the knee. It is common, that you get the problems when you are running and later you might also have the same problems walking.

To prevent this, there are a few IT band Yoga-poses available. If you don’t want to do yoga, you can still use these poses simply for stretching. That’s really what you need to prevent problems with the IT-Band.
If you want an explanation of the poses below, you can find most of them on Youtube. Or you can also find them explained in The Athlete’s Guide to Yoga: An Integrated Approach to Strength, Flexibility, and Focus.

The following poses are known to be good for preventing IT-Band problems:

• Square
• Cow face forward fold
  
• Pigeon
• Outer hamstring twist
• Outer thigh twist
• Half lord of the fishes twist
• Cross-legged reclining twist
• Frog legged pose

For more reading about Yoga and Triathlon please visit The triathletes 9 reasons for doing Yoga or Yoga and Triathlon.

You also might want to take a look at this podcast from Sage Rountree.  She shows you how to do some very efficient exercises to prevent you from getting an IT band problem. Here you can find a review of her Yoga DVD the athlete’s guide to yoga.

Here is an article with more information about ITBS and here is a link to a post showing some products for ITBS.