This condition frequently occurs in long distance runners, sprinters, cyclists, and triatheletes. ITBS presents as a sharp or burning pain on the lateral aspect of the knee. It can also cause pain to radiate up the side of the hip or thigh.   

ITBS is an overuse injury caused by the repetitive action of the iliotibial band (ITB):

§         As it moves across the lateral femoral epicondyle.

§         When the knee is flexed at an angle greater than 30 degrees, and the iliotibial band moves back behind the lateral femoral epicondyle.

§         During knee extension, when the iliotibial band shifts forward in front of the lateral femoral epicondyle.

When the ITB is shortened or stressed, the repetitive actions of the knee during running and walking causes friction and inflammation of the iliotibial band. With ITBS, the bursa often becomes inflamed, manifesting as a clicking sensation as the knee flexes and extends.

Treatment of ITBS:

In order to provide effective treatment, the practitioners must ensure that the structures in the kinetic chain of the iliotibial band (above and below the area of injury), as well as the ITB itself, perform properly. Patterns of dysfunction will continue to develop if any segment of the kinetic chain is not functioning properly.

Effective treatment of ITBS, like that of any other soft-tissue injury, requires an alteration in tissue structure to break up the restrictive cross-fiber adhesions and to restore normal function to the affected soft-tissue areas.

To truly resolve ITBS, every structure that crosses the lateral side of the knee must be evaluated and treated, including:

§         The iliotibial band to release the restrictive adhesions that attach the ITB to surrounding structures.

§         The muscles, ligaments, menisci, and knee capsule that form part of the iliotibial band's kinetic chain.

§         The hip where restrictions in the psoas, and internal and external hip rotators are the most common cause of ITBS.

Treating ITBS with ART

Active Release Techniques (ART) is a patented, non-invasive, soft-tissue treatment process that both locates and breaks down scar tissue and adhesions that cause pain, stiffness, weakness, numbness, and physical dysfunctions associated with Repetitive Strain Injuries.

Practitioners must consider tissue texture, tissue tension, tissue movement, and tissue function. Each of these factors can cause the ART practitioner to greatly alter their treatment.

Once the ART practitioner has identified the specific entrapment site, and has the lesion (scar tissue/adhesion) under specific contact with his/her hand, the Practitioner takes the tissue from a shortened to a fully elongated position, while moving longitudinally along the soft tissue fibers.

During the ART treatment, the tissue is moved by the practitioner, in a vector that follows the direction of the tissue fibers. At the same time the patient is asked to execute a movement that causes the tissue to either move with, or away, from the practitioner. When this happens, the practitioner can literally feel the tissues translate in one direction while the adjacent tissues move in an opposing direction. Almost immediately, the patient will feel a release. They will also feel a corresponding increase in function with all their physical activities.

The Practitioner uses ART to:

§         Restore optimal tissue texture, tension, and movement.

§         Restore the   strength, flexibility, relative translation, and function of the soft-tissue.

§         Release any soft-tissue restrictions, entrapped nerves, restricted circulatory structures, or lymphatic restrictions.

Dr. Brian Abelson is the Clinical Director of Edgemont Chiropractic Soft-tissue Management Systems, in Calgary, Alberta. 

Dr. Abelson is a native Calgarian who attended the University of Calgary, majoring in Biosciences, before graduating from Palmer College of Chiropractic West, California with an award for Clinical Excellence. He holds advanced certification in all levels of Active Release Techniques, is trained in Biomechanics and ART, is an accomplished ART Instructor, and is licensed to the ART Elite Providers Network.

He is co-author of "Release Your Pain" the first book for the public about Active Release Techniques. He is also the co-author of the award-winning information websites: www.drabelson.com and www.activerelease.ca.