Q A specialist diagnosed me as suffering from iliotibial band syndrome as a result of overpronation, gave me two simple stretches for my hamstrings, and then told me that I’d need orthoses. These will be very expensive – is there anything I can do before committing my cash?
A The iliotibial band runs from the hip down to the knee. Iliotibial band syndrome (ITBS) is commonly felt on and across the outside of the knee. You’ll feel discomfort if there’s too much load or friction on the ITB, and it’s usually worse when you extend the knee. But I suggest that you get a second opinion as to whether this diagnosis is correct.
I say this because, if the iliotibial band is the source of your problems, then stretching the hamstring group won’t really help. It’s actually more likely that you’ll have a weakness in your hips, which is causing the increased strain on the structure.
You should have your gait analysed and your muscles checked for any form of imbalance before committing to orthoses. This will provide invaluable information on how you move when you run and how much ‘motion control’ you need if you really do overpronate. If you do, you may find that this can easily be controlled with off-the-shelf motion control shoes.
In the meantime, try this stretch for your ITB. Cross the affected leg behind the good one and rest on the outer edge of your front foot. Then, making sure your pelvis is straight and not rotated, move your hips towards the affected side as far as you can. You should feel a stretch on the outside of the hip and down the thigh. Hold for 30-45 seconds and try to do this around 15 times a day.
—Andrew Caldwell, chartered physiotherapist