ILLIOTIBIAL BAND (ITB) SYNDROME

ILLIOTIBIAL BAND SYNDROME

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The Tensor Fascia Lata is the tiny muscle that attaches to a huge fascia-like tendon called the Illiotibial Band (sometimes called the ITB or Illiotibial Tract).  This band of tissue runs from the illium (the hip bone) to the distal lateral tibia (lower, outer knee), and covers the entire outer portion of the thigh.  Because it crosses both the hip and the knee, it is very capable of causing problems at both joints, although the pain is frequently — especially in runners (the people who seem to develop this problem most often) — seen at the outer knee (knee pain) — probably why I think it’s related to PATELLAR TRACKING SYNDROME (aka Patello-Femoral Syndrome).  Although ITB Syndrome can somewhat mimic the leg pain seen in sciatica, never confuse the two.

As you can imagine, problems with the ITB and TFL are frequently related to other problems as well.  I frequently see ITB issues in people who are struggling with chronic PIRIFORMIS SYNDROME.  You can also see how the TFL is in the vicinity of all sorts of muscles and tissues, including the hamstrings and quads.  The beauty of treating a ITB / TFL Syndrome is that the model for treating all of the ELASTIC, COLLAGEN-BASED CONNECTIVE TISSUES is essentially the same.  To understand this process, simply look at my pages on FASCIAL ADHESIONS and TENDINOSIS.

As you can imagine, improper foot mechanics could, as in all lower extremity problems, can be a tremendous contributing factor with ITB Syndrome as well.  This would necessitate being fitted for orthotics or different shoes.  Sometimes there are muscle imbalances that have to be dealt with also.

TENSOR FACIA LATA & ILLIOTIBIAL BAND
  IS IT FASCIA, TENDON, OR SOMETHING ELSE?

The Tensor Fascia Lata is a small muscle with a disproportionately long tendon.  This tendon stretches all the way from the hip to the lateral portion of the knee, with fascial attachments actually crossing the knee.  The Tendon is called the Illiotibial Band (aka Illiotibial Tract or ITB). 

Although it is difficult to tell from either of these drawings, the Tensor Fascia-Lata (TFL), which is actually not a fascia but a tendon, is so wide that it covers up all the deeper muscles of the lateral thigh.  The top portion of the ITB might be 3-4 inches wide, but the much narrower bottom attachment is where runners experience “Runner’s Pain” or “Runner’s Knee.

Fortunately, this is a problem that can frequently be dealt with via Tissue Remodeling and some simple changes in biomechanics.


ITB Syndrome

PHOTO BY Beth O’Hara

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