Iliotibial Band Syndrome, Rugby Injury
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Iliotibial Band Syndrome & Rugby





The Iliotibial band (ITB) is a band of strong tissue that originates from the outside of the pelvis and attaches to the outer part of the knee. This is why the player will complain of pain on the outside of the kneecap. Excessive strain during running can cause shortening of the tendon which in turn causes the tendon to rub on the knee. This friction movement causes the player pain. This condition may drastically limit or even completely stop your training.

Symptoms and Causes

Symptoms of the iliotibial band syndrome (ITBS) include pain or tenderness on the outside of the knee. The pain may start near the end of a training session.

An associated condition to ITBS is trochanteric bursitis which is basically a sack of fluid present at the hip joint. As the knee flexes and extends the iliotibial band rubs. During flexion and extension of the knee the iliotibial band rubs over the femoral condyle (two heads that sit on top of the iliotibial band) which leads to irritation. Weak hip abductors and gluteus medius are often a predisposing factor.

The Gluteus Medius muscle is situated at the top of the buttocks and its primary function is to raise both legs out to the side and turning the hip inwards. The muscle prevents the thigh from buckling and rotating forward as the player is running. If the gluteus medius is weak the knee will buckle which will strain the ITB.

The hip abductors main function is to abduct the leg (push it out towards the side). If these abductors are weak the ITB has to work harder and can get strained, Other factors to bear in consideration is players with bow legs, over pronation and leg length discrepancy.

Running in circles also places considerable stress to the ITB. Recent studies have shown that athletes running in circles have a higher incidence of ITBS. The angle of force being applied to the ITB is much greater and therefore predisposes the knee to this injury.

How it affects Rugby

This is a classic sign of over training or a over eager rugby player doing excessive running including hill work or incline treadmill running.

Treatment of Illiotibial Band Syndrome

Initial treatment should consist of an ice pack which will reduce inflammation. Anti inflammatory drugs will help to reduce the swelling. Reducing training intensity and mileage work is advised. A deep tissue massage is also advised.

Other treatments include:

• Orthotics will redistribute pressure away from the ITB and address any underlying over pronation.
• The player may need a heel life to address a limb length discrepancy.
• Regular ITB Stretches, view below.
• Wear a knee strap to relieve symptoms
• In some severe cases where rest and ice fail to settle the symptoms fully, then a corticosteroid injection into the area of the bursa over the Lateral Epicondyle of the thigh is usually very effective.
• Strengthening the hip abductors and gluteus medius muscles.

Illiotibial Band Stretch

Sit with your injured leg bent and crossed over your straightened opposite leg. Twist at your waist away from your injured leg, and slowly pull your injured leg across your chest. You should feel the stretch along the side of your hip. Hold the stretch for 10 to 15 seconds. Repeat the stretch six to eight times. This stretching exercise may be helpful for Illiotibial band syndrome and adductor strain.

We also recommend the use of sports orthotics/ insoles to dramatically speed up recovery time. Knee supports (view below) provide compression and stability to the affected muscle to increase the healing phase of the injury.

View elasticated knee support


Self treatment for this problem should include:

• Temporary decrease in training
• Side Stretching
• Shorten your running stride
Use orthotics with arch supports.
• Strengthen your hip abductors (gluteus medius, etc.)

Rugby Rescue Recommends

Treat the underlying cause of Iliotibial Band Sydrome

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