Sports Medicine
A Crucial Period
Good Pain, Bad Pain
On Your Knees
Secondary Injuries
Imaging Technology
What's Sciatica?
The Female Athlete
Putting Your Feet First
Itis Schmitis
Too Much, Too Soon
Under the Influence
What's Goin' On?
Think Inches, Not Pounds
Preventing Vaginitis
That Painful Pull
Athlete's Heart
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Chilled to the Bone
Measuring Body Fat
Exercise and Your Breasts
Choosing a Sports Doctor
Lean on Me (Shoulder)
Exercise & Anemia
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Pelvis Sighting
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It's All in the Wrist
Back in Action
Altitude Adjustment
Tennis Elbow, Anyone?
Exercising in the Heat
Agony of the Feet<
Restless Legs
Night Time Cramps
Birth Control Concerns
No Periods, No Babies?
Post Partum Prescription
Weight Loss Mystery
Undesirable Cooldown
To Brew Or Not To Brew
Fitness After Baby
Biking and Back Pain
Swimmer's Shoulder
A Hidden Athlete
Avoiding Osteoporosis
Drug Testing
Maximum Heart Rate
Headway Against Headaches
Torn Rotator Cuff
Fat Figures
Bloody Urine
Sag Story
Lackluster Leg
Bothersome Bulge
Gaining in Years
Taking It On the Shin
Aching Ankles
Hoop Help
Tender Toes
Meals For Muscle
Growing Pains
Hot Tips
High Altitude PMS
Personal Bests
Air Pollution
Ankle Blues
Heartbreak Heel
Yeast Relief

Lackluster Leg - Iliotibial Band Syndrome

Q: I am a 30-year-old woman who has exercised her entire life. I have run four marathons, but each time I train at long distances my iliotibial band (ITB) becomes a problem. I get a sharp pain on the side of my leg just above the knee.

Sometimes I feel a snapping or popping in my hip or around my knee. During my last marathon, it was so severe it felt like my knee was going to collapse, and I had to stop, stretch, and walk for a while. I do stretch regularly.

Could you explain what causes iliotibial band syndrome and suggest anything else I can do to clear up this annoying problem? Is my marathon "career" over?

Sandy, UT

A: The ITB is a thick strip of fibrous connective tissue that runs from the top of the pelvic bone and along the outer side of the leg to just below the knee, where it attaches to a bony protuberance of the lower leg.

As your knee flexes, the ITB rubs over the femur (thigh bone). With increased mileage or a new training style it can fatigue, tighten, and rub excessively. The rubbing is accentuated the more you lift your knees.

Usually the ITB becomes irritated either directly over the bony protuberance at the side of the hip, or on the side of the leg an inch or two above the knee, but it can become inflamed along the entire length. A sharp pain is usually felt near the surface, sometimes accompanied by a snap or pop.

The pain can be reproduced by standing on the affected leg and then bending the knee 30 degrees or by pressing directly over the band as it crosses over the femur. Other conditions can mimic ITB pain, so a careful evaluation by a sports medicine specialist is essential.

This irritation can seem like a minor annoyance at first and then go on to become a major problem due to the underlying cycle of inflammation, swelling, and scarring. ITB syndrome represents 20 to 25 percent of knee injuries in runners.

What causes ITB syndrome?

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Foreword: Billie Jean King

Comments by Barb Harris
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