If you have a slight tightness in the side of the thigh, or pain when walking down stairs or running downhill, you may suffer from Iliotibial Band Syndrome. The iliotibial band is a superficial thickening of tissue on the outside of the thigh and leg. This band starts of the outside of the pelvis and runs over the outside of the hip and knee, inserting just below the knee.

It has been a primary cause of lateral knee pain in runners as well as other athletes. The injury is believed to be caused by friction between the outside hip bone and the iliotibial band, or a development of a bursa tissue between the two structures, with accompanying inflammation.

While running, the iliotibial band works to stabilize the knee. Before and during foot strike, the band helps to rotate the leg inward to stabilize it during that phase of running. As the knee bends and the foot pushes off, the iliotibial band moves from behind a prominence of the hip bone and to the front of it. It is the continuous rubbing of the band over the bony prominence that causes a problem.

The individual will usually experience pain over the lateral lower hip bone. He will be able to walk long distances or play other sports such as squash or tennis without discomfort, but walking downstairs may aggravate the pain. Any downhill running will also create marked pain.

Treatment is directed towards correcting the painful rubbing of the iliotibial band over the lateral lower aspect of the thigh bone. Stretching it every day, especially before running, will help make the band more flexible and less prone to injury. One should also decrease mileage, if you are a distance runner. If you run on a pitched surface, either the shoulder of a road or track, try to alternate the direction in which you run.

This change will eliminate your putting too much stress on the iliotibial band of one leg. When returning back to your running program, do so in moderation and run on soft surfaces. Also avoid downhill running. In the more severe cases, anti-inflammatory medication and foot orthotic devices may be helpful in rare instances, a last resort may be partial surgical release of the thigh band, however this procedure is not warranted unless conservative methods have failed.

The long term prognosis for iliotibial band syndrome seems to be fair to good in most cases, although some individuals can have recurring problems if they go back to high mileage too quickly. It is important to start back slowly to build a solid foundation in order to gain speed and distance.

Dr. Robert F. Weiss is a sports podiatrist specializing in foot and ankle surgery. He was a member of the Medical Advisory Committee of the 1984 and 1988 Olympic Marathon Trials. Dr. Weiss is a veteran of 35 marathons, has a practice in Darien and resides in Westport. For more information visit his Web site at www.therunningdoctor.net.