The first symptom may be a nagging pain in the outer knee that comes when you start exercising and fades away as you warm up. But then it stops fading. Instead, the pain gets worse. It moves up from the knee, along the thigh, even to the hip. What’s causing it?
The pain may come from the iliotibial band, the longest tendon in the body. The IT band attaches muscles in the hip to the tibia bone in the lower leg, stretching down the thigh and over the side of the knee.
There’s a bony bump, or knob, on the top of the femur, over which the IT band passes. (For anatomy geeks, the knob is the “lateral femoral condyle.”) In sports where the knee is bent and straightened a lot, such as running, biking or cycling, there can be friction at this spot from overuse of this tendon.
If not immediately addressed, the friction can inflame the entire band. Then comes the serious pain. It hurts when the knee is bent, it hurts when the foot strikes the ground, it hurts when going down stairs. You can’t “work through” inflammation, it will only get worse and recovery will be harder and take longer.
This is an overuse injury. It’s so common that it even has a name; IT band syndrome. If you’re an athlete, it can cost you a season, even a career.
However, there are ways to help prevent IT band syndrome. Start some of these basic preventive measures before you even feel any twinge of pain in your outer knee.
The most important prevention, as always, is good form. Make sure you’re riding, running or doing any other kind of activity with proper form. Ask coaches to assess your technique, or even pay for a professional assessment from a physical therapist.
Next in importance is conditioning. This includes both building in strength in the core and legs, and stretching — specifically stretching this long tendon. For a good IT band stretch, lay on your side, bend the lower leg to the knee of the leg on top. Then grab the ankle of the upper leg and pull the foot to the butt. Keep your spine straight while doing this stretch, don’t arch your back.
The third most important way to prevent this overuse injury is to take it easy when increasing mileage or any other knee-bending activity. Don’t suddenly and drastically increase the amount, frequency or intensity of your training. Make increases gradual, and give your body time to adjust to the new load before adding anything more.
While in prevention mode, always warm up well before training or racing. That’s “always,” as in, never ever skip a warm up.
If the pain is already serious, don’t hesitate. Find a good physical therapist or athletic trainer. Work with him or her to heal the inflammation. The quicker you take care of the situation, the faster you’ll be able to get back into pain-free action.