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ITB syndrome is the most common cause of lateral knee pain in running. 
It often presents as a sharp pain or feeling of tension around the lateral aspect of the knee which increases the further you get into your run. Often people who suffer from this condition feel like the outside of the knee is going to “snap” and are fearful this could cause significant disability… however the ITB is a very strong structure and will not break from an activity like running. 
Other common symptoms of this syndrome are increased pain when walking or running down hills or pain felt when walking down stairs. 
Much like patella femoral pain (see my last blog) the main cause of ITB syndrome is training error. The majority of cases I see in the clinic usually occur from a significant increase in training load or effort. The good news is that something as simple as a reduction in training load for a short while can often remedy the situation. 
 
If you are suffering pain caused by ITB syndrome making some adjustments during your run can be beneficial. Try to avoid lengthy periods of time running on the same road camber (cross from one side of the street to other regularly) also reducing the amount of downhill running can help. If you run with a narrow stride width (left foot lands almost on the same line as the right foot) then increasing your stride width (running with a slightly bigger gap between the line of foot placement) can also help. If you are considering changing your stride width when running this should be integrated gradually, I usually advise my patients to initially try the new technique for 1 minute per every mile run. 
Local deep tissue massage and stretching the ITB are not always helpful when treating this condition. Current opinion is that the cause of discomfort from ITB syndrome is due to the structure compressing tissue rich in blood vessels and nerve endings hence these techniques tend to exacerbate the condition by compressing the same sensitive tissue. 
Assessing the strength of the musculature around the hip joint and knee joint, as well as your ability to control the movement of these joints can be beneficial. Establishing an exercise programme to address strength and movement control issues identified will contribute towards reducing pain and recurrence. 
If you feel you may have ITB syndrome and would like further help, please feel free to contact us for a consultation. 
We are currently offering face to face and remote consultations during the Covid 19 pandemic. Certain criteria including assessment of your vulnerability to Covid 19 is required before you attend your appointment. Appropriate PPE will be worn and all infection control procedures as per NHS and HSE guidelines will be followed. 
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