• Manual Therapy- the use of physical “hands on” techniques to treat health problems. Manual therapy includes such treatments as massage, Active Release Technique, joint manipulation, trigger point and Fascial Distortion Model.

In my experience as an athlete and a sports doctor, patients with recent sports injuries can get better rapidly, in only a few visits with manual therapies, such as Active Release Technique.   But when rehabilitation exercises are used as the only treatment protocol, patients have considerably longer treatments and much slower recoveries.

The best way to treat most sports injuries is to first use manual therapy techniques and THEN to teach patients rehabilitation exercises.  Manual therapy is used first for many reasons, the most important of which is that it is the quickest method to reduce pain and get people back to their activity/sport.   Rehabilitation exercises are only then used to strengthen and stabilize the body after the injury is improved.  There is no point in strengthening and stabilizing tight and restricted joints, fascia or muscles (pain producing conditions).  At my office, we use various manual therapies, our favorite of which is Active Release Technique, on most patients to fix the cause of their pain.  We then teach exercises to help prevent recurrence and to reduce the number of total treatment visits required.

What is the iliotibial band?

The iliotibial band (ITB) is a long thickened sheet of fascia that starts at the hip and extends to the knee. This band of fascia connects the tensor fascia lata and gluteus maximus muscles to the thigh and knee. The ITB gives support to the outside of the knee and patella.

What causes iliotibial band syndrome?

There are a large number of problems that cause or contribute to ITBS. Take a look at the following list – leg length difference (shorter leg hurts), crossover gait, hip muscle tightness, quadriceps weakness, poor knee alignment, internal tibial rotation, and a tight calf muscle and Achilles tendon. For cyclists, pedal position forces the leg into internal rotation on the pedal causing increased friction of the ITB at the knee.

What to do?

If you are a runner, running faster generally helps. Running at faster speeds, changes the angle that the knee achieves which decreases the amount of friction at the knee. Obviously, you will run faster for a much shorter distance. I suggest you run 1/4 to 1/2 of your previous volume but increase your speed by 10-20%.

Hills are not a good idea. Walking or running downhill will make you worse. The amount of friction increases while going downhill.

Deep tissue or friction massage at the pain site and stretching the lateral thigh is the fastest means of healing this problem. Rolling the outside thigh on a foam roll often greatly helps this problem. Also, icing the area will reduce any inflammation and pain that has developed.

I’ve helped many runners and non-athletes with this problem. I’d love the opportunity to help you!