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© Cool Sports 1997
Updated August 22

Massage therapists are not doctors. We do not diagnose illnesses, diseases or any other medical conditions nor do we prescribe medications or any form of treatment(s). Information contained in this article is for reference only and is intended for the average person. Therefore it is not technical in nature. It is based on my training in massage/muscle therapy, experience with clients in my practice and personal experience having dealt with it myself in the fall/winter of 1996. Please consult your healthcare practitioner for a proper diagnosis and treatment options. In health, -Norm

ITB Syndrome is characterized by pain on the outside of the knee. It may extend just slightly above or below the knee. The sharp pain may come on suddenly, usually at or beyond the half-way point of your typical run as your muscles begin to tighten-up. In my case, it started as a mildly cramping calf and within a quarter-mile I couldn't flex the knee without sharp, stabbing pain. It was a long, uncomfortable walk home.

The ITB runs from the front/outer portion of your hip down the outside of the thigh to the knee, imagine the point at which your quads & hamstrings come together. You will feel it as a tough, fiberous band about 1-2 inches wide. It is typically tender to pressure - even in individuals that don't have a problem with it.

Some factors that may contribute to ITB syndrome are:

• Bowed legs.
• Leg length differences.
• Pronated foot.
• Side of road running.
• Lack of flexibility.
Treatment Protocol:

• Immediate self-care: Ice, ace bandage, rest, massage, cut-back on running schedule - perhaps eliminate altogether for short term.
• Orthopedic MD: Xrays to rule out slight fractures, bone spurs, check for joint spacing issues & cartilage problems, etc. Manual tests for ligament & meniscus problems.
• Physical Therapy: Double check MD manual test results. Check for other potential contributing problems . May perform therapies such as ultra-sound, muscle stimulation, etc. Should teach injury specific stretching and strengthing.
• Massage/Muscle Therapy: Trigger point therapy & deep tissue work to promote flexibility, breakdown adhesed tissue, increase flow of blood and lymph fluids to the injured area, assist with passive stretching.
• Podiatrist: Check for foot and gait problems, fabricate orthotics if necessary.
• Long-term self-care: Consistent stretching routine. Monitoring training schedule, types and lengths of runs, types of shoes and any discomfort noted. Listening to your body and backing off as need be.

Of course, depending on the severity of your injury you may not need to do something so extensive. However, if after a few days of the initial injury you don't feel improvement then you should seek further medical intervention. The severity of your injury and your dedication to a rehab program may give some indication as to how long your recovery time will be. I've seen some clients with mild cases respond within 4-6 weeks and a full training routine incorporated along the way.

For me, probably due to some of the most inflexible body parts on the planet, it was almost a full 5 months before I felt good during a daily run of 3-5 miles. Despite now being relatively pain free, I've had to incorporate other activities like trail running, more hiking, backpacking, and x-country skiing as a means of cross training to keep the ITB demons away. ITB syndrome is not a death sentence but just another health problem that you can deal with. Improperly treat it and you will be miserable.




Norm St.Onge, a massage & muscle therapist, is MA & NH licensed and internationally certified . He is the owner of ProTouch; Professional Massage & Muscle Therapy in Townsend, MA. and is a member of the American Massage Therapy Association, Associated Bodywork & Massage Professionals organization, and the Nashoba Valley Chamber of Commerce.
Email: protouch@tiac.net
ProTouch Massage/Muscle Therapy self-care products (note: off-site link)

© Cool Running 1997