Knee pain caused by ‘Iliotibial Band Friction Syndrome’: What it is and how it can be treated

What are the symptoms?

It is very common among distance runners. It can start as a nagging pain on the outside of the knee. When you begin your run, it does not hurt at first.  After logging a few miles, the pain begins. It will generally go away after a short rest. I know this situation well because I had the problem when I was about 30-years old and was logging about 25 miles per week. A worse stage occurs when the pain is more persistent. The area can hurt even during walking, and especially when climbing or descending stairs. The condition can also occur in other sports as well, such as skiing, cycling or weightlifting—any sport that demands repetitive flexing and extending of the knee.

How does it develop?

The iliotibial band is a thick band of fascia that begins on the iliac crest as a muscle, the tensor fascia latae, and crosses the knee in its tendinous form to attach to the tibia. With repetitive movement, the band rubs against the condyle of the femur and the tissue gets irritated and inflamed.

What predisposes an athlete to developing it?

It is common to see an elevated pelvis on the side of the injury. Shortened adductor muscles and weak abductors are often found, along with excessive pronation of the foot. (1)

How do we fix it with acupuncture? Three strategies.

1) Activating the flow of healing energy in the acupuncture channels that cross the affected area. I also use a variety of different points to balance the energy of the whole body. This strategy derives from traditional Oriental medicine and in itself helps with pain reduction and healing. With the correct points, it can contribute to balancing the musculature of the pelvis.

2) Using acupuncture to target local tissues, in this case the iliotibial band at the area where it is inflamed.

3) Releasing tight muscles with acupuncture and myofascial release techniques to eliminate trigger points and restore the balance between opposing muscle groups. Eliminating trigger points will help loosen the IT band so that there is not as much friction at the insertion near the knee. It is also important to release trigger points in the tensor fascia latae muscle on the lateral hip because they can refer pain along the course of the IT band. 

Duration of therapy

For low mileage runners, skiers or cyclists, two treatments per week for 2-3 weeks should suffice. For high mileage athletes, the treatment will usually take longer. It is good to avoid any activity that exacerbates the condition during the course of therapy. (2)

 (1) Matt Callison, L.Ac., Sports Medicine Acupuncture, San Diego, CA. Acusport Education, 2019, pp. 825-826
(2) Ibid p. 828

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