Is your knee pain due to IT Band Syndrome? For some runners the pain levels can be very high, causing them to stop running and obviously that is disruptive to training.
IT Band Syndrome or to give the condition it’s full name … Iliotibial Band syndrome (ITBS) …. is one of the leading causes of lateral knee pain injuries in runners … estimated to be in the range of 5–14% prevalence of all running-related injuries.
In this episode we’ll be describing IT BAND SYNDROME and the underlying causes. We won’t talk about the physical therapeutic treatments or preventative exercises (we’ll leave that for you to consult with your physio or sports therapist). However, as pain and inflammation are synonymous with IT Band Syndrome, we’ll cover …
· The risks associated with chronic use of painkiller medication
· Nutritional support for managing inflammation status
What is IT Band Syndrome?
The IT band is a thickened band of tissue that runs all the way down the length of the outside of your thigh. The IT band works with your knee ligaments to help stabilise your knee joint. There are various theories around why ITB syndrome happens, but the common theory is that the condition is an overuse injury resulting from the IT band rubbing repeatedly against the lower end of your thigh bone as it joins your knee. This friction causes inflammation and pain. It’s also thought that other contributors are weak muscles in your hips or knees, or tightness in your IT band, and having slight differences in the length of your legs.
Why are runners at risk of developing IT Band Syndrome?
ITBS is often described as an overuse injury, and it develops due to activities where you bend your knee like running. Some of the risk factors leading to ITBS include increased running distances, increased volumes of downhill running or fast running. The severe knee pain experienced may have been preceded by a recent spike in running loads … so that may be for a new runner or for someone who is increasing training distances over a short period of time.
How do runners describe the symptoms of IT Band Syndrome?
People talk about a sharp pain or ache on the outside of the knee, which may spread up or down the leg, and sometimes towards the hip. The outside of the knee may be tender to the touch and there may be some swelling. Usually, you’ll only feel pain during an activity like running or cycling, it may feel worse when running downhill. Often you can start a run pain-free, but the pain develops during a run and is alleviated by stopping. Unfortunately for some, the pain can affect them when walking or sitting too.
The importance of a correct diagnosis from a professional sports injury specialist.
Take professional advice from a physiotherapist or sports therapist as soon as you notice any knee pain. They will be able to professionally assess your situation, they’ll consider symptoms and your run training including; mileage/frequency/type of training. They may assess muscle strength and extensibility (that’s the ability to extend or stretch) and they’ll also be assessing the muscles attached to the IT band.
What do runners need to take into consideration regarding pain management and IT Band Syndrome?
The severe knee pain associated with ITBS will be alleviated by stopping running as soon as you experience pain. If you stop and the pain is alleviated perhaps there would be no need for pain management.
The cautionary word is do not be tempted to take painkillers so you can run through the pain. Pain is the body’s alarm to tell us something is going on! If pain medication is used, the perception of pain is decreased, so it’s bearable whilst running, but that is masking the injury so in the longer-term we may be doing damage.
In our view pain medication should be used in acute situations and only in chronic conditions under medical supervision. Your medical practitioner or sports injury specialist will advise you on pain medication for short term use in relationship to your injury.
Health Risks associated with chronic use of painkillers include:
· Liver and Kidney Disorders
· Exercise associated hyponatraemia
· Gut and Digestive Issues
· Delayed healing of musculoskeletal injuries
We have an episode on this Episode 53 Painkillers for Running? In that episode we talk about when it’s safe to use painkillers and NSAIDS like ibuprofen and we highlight some nutrients which would be supportive in the management of pain and inflammation.
If you are a runner who is living with a health condition or an injury which is affecting your run training, please book a complimentary WORK with US call and we can advise the best way forward.
Why managing your inflammatory status may support recovery from IT Band Syndrome.
The inflammatory response is a natural response to deal with any pain or injury or infection. The immune system triggers an inflammatory response to deal with the situation. Immune cells identify a stressor and take action to resolve the issue, in the case of ITBS, the immune system is aiming to resolve the injury. A healthy immune system balances a pro inflammatory and anti-inflammatory response to manage the healing process. In an acute injury, pro inflammatory mediators are released to help to increase blood flow in and around the site of injury and that enables pro inflammatory immune cells to do their job.
The importance of preventing a chronic inflammatory status.
The term “chronic inflammation” describes a situation where a chronic injury or illness is ongoing and not fully resolved. It’s also a symptom of other health conditions, such as rheumatoid arthritis or other autoimmune disorders. Some people are in a state of chronic inflammation for example due to a poor diet, being obese, drinking too much alcohol or smoking.
Why are we sharing all of this? Well, it’s because if we are healthy with a balanced immune system and then experience and injury, we are more likely to heal and recover swiftly. If we are in a chronic state of inflammation before an injury the immune system may not be able to work effectively. Also. if we keep running through an injury, we are likely to create a chronic inflammatory status.
How Omega 3 Fatty Acids in your food plan can support anti-inflammatory actions.
Omega 3 Fatty Acids which are known to have an anti-inflammatory action. Within the Omega 3 family there are DHA and EPA which contain Specialised Pro Resolving Mediators known as SPMs and they have an active role in resolving inflammation and healing.
The SPMs are involved in balancing the inflammatory response, following the INFLAMMATION initiation phase of an injury they reduce pro inflammatory cells entering the area and promote more anti-inflammatory cells. This helps with tissue repair and resolving low grade chronic inflammation. The richest dietary source of DHA and EPA is from oily fish.
How do you ensure an optimal intake of Omega 3 fatty acids if you don’t eat oily fish?
The body can convert another Omega 3 fatty acid which is from plant sources into DHA and EPA, this is ALA (alpha linoleic acid) however the conversion is not efficient so people following vegetarian or plant-based food plans should consider supplementing with an EPA and DHA supplement derived from microalgae.
Omega 6 Fatty Acids in relationship to Omega 3 and inflammatory status.
An important aspect of nutritional status is to consider your Omega 6 Status in relationship to Omega 3 – a bit like the immune system there needs to be a healthy balance between Omega 6 and Omega 3. If you have too high a ratio of Omega 6:Omega 3 this may promote an inflammatory status.
How do you test your Omega Status and Aileen’s recent results.
You can do a blood spot finger prick test and the test results will give you a breakdown of the status of Omega 6 and Omega 3 fatty acids. It can be an informative test as you can see immediately which individual fatty acids you may need to focus on to have an optimal status. If you are interested in finding out more please book a complimentary work with us call and we can explain which test would be helpful for you.
Foodie Tips on Omega 3 Fatty Acids
Plant-based sources of Omega 3 are ALA – alpha lineolic acid – the richest sources of ALA are from walnuts, chia and flaxseed. An easy way of adding these to your food plan would be to add to porridge, overnight oats or yoghurt as part of your breakfast. Some people like a Chia Pudding, or you could bake as part of a flapjack recipe or bounce balls or even blend into a smoothie.
DHA and EPA Omega 3’s are from oily fish – the small fish are best – remember the acronym SMASH for sardines, mackerel, anchovies, salmon and herrings. Also as mentioned earlier you may need to add an Omega 3 supplement if you don’t eat oily fish on a regular basis or if your test results indicate a deficiency.
Foodie Tips on Omega 6 Fatty Acids
Omega 6 fatty acids are mostly found in nuts, seeds and vegetable oils. Omega 6 fatty acids in vegetable oils are often used in the production of processed and prepared foods. It can be easy to over consume Omega 6 oils e.g., shop bought hummus may be made with. vegetable oil or canned sardines or tuna may be packed in sunflower oil. So, it’s worth checking labels of all foods but especially foods which are considered to be “healthy foods”.
If you do have a test result which indicates a high Omega 6: Omega 3 ratio, the best approach is to increase your Omega 3 intake and focus on those nutritional co factors for conversion – they are B3 and 6 Vitamins Vitamin C, Zinc and Magnesium. It takes approx. 4 months to influence your fatty acid status with supplements and food.
Key Take Aways
1. ITBS affects many runners and is categorised as an overuse injury.
2. Key symptoms are stabbing knee pain which develops during running activity and often will be alleviated when a runner stops. Pain may spread up or down the leg, and sometimes towards the hip. The outside of the knee may be tender to the touch and there may be some swelling.
3. Risk factors for ITBS are increased running distances, increased volumes of downhill running or fast running. The severe knee pain experienced may have been preceded by a recent spike in running loads.
4. Other contributors to ITBS are weak muscles in your hips or knees, tightness in your IT band, and having slight differences in the length of your legs.
5. Our best advice is to consult with a Physio or Sports Injury Specialist as soon as you experience pain. Please don’t run through the pain or use painkillers to mask the pain.
6. Your sport injury specialist will professionally assess your situation and consider symptoms and your run training including mileage/frequency/type of training. They’ll personalise a recovery plan for you.
7. Following a nutrition plan which supports a healthy immune system and a balanced inflammatory status will be supportive to recovery and injury prevention.
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The suggestions we make during this episode are for guidance and advice only, and are not a substitute for medical advice or treatment. If you have any concerns regarding your health, please contact your healthcare professional for advice as soon as possible.
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Best Wishes and Happy Running!
Karen and Aileen