ITB syndrome. A symptom.

The first reply to my suggestion for topics was for Iliotibial band syndrome and this is another good example, similar to plantar fasciitis, where the pain is not where the problem is.

To understand the problem you have to understand how knee stability works.  Essentially, to maintain good knee control, the body uses the primary knee stabilisers which include the vastus medialis oblique (VMO - part of your quads muscle found above the knee on the inside of your leg) and the gluteus medius muscle which is found in your 'gluteal region' (bum) on the side of the body.  These muscles work, with the other muscles of the pelvis/buttocks/thigh, to control the way that the knee moves as load is accepted onto the leg.

If this control system fails, then other structures around the knee take the load and these can be called the secondary stabilisers and include the medial hamstrings (semimembranosus, gracilis and semitendinosus) which insert below the knee joint on the inside of the leg onto the tibia (shin bone) and the iliotibial band which starts at the ilium (part of the pelvis), runs down the outside of the thigh and inserts into the tibia on the outside of the leg (but also feathers into the outside of the knee joint and the kneecap joint).

The reason that the primary control system might fail could be due to lack of strength and control through disuse (i.e. you never had the control) or injury (you had it, then you lost it).  In particular, if you develop an effusion of the knee (fluid in the knee joint) perhaps because you bash the knee on a rock or similar, then the VMO will often switch off. 

So the primary control system isn't working.  You keep loading the knee.  The secondary stabilisers take over - but they are not designed to work alone and they tighten up and become overloaded - ITB pain. 

The treatment for ITB syndrome includes stretching off the ITB and TFL (tensor fascia lata - muscle that feathers into the ITB at the pelvis) but you will never be rid of ITB pain until you sort out the stability issues around the knee. 

You can test your knee and hip strength and control by attempting a single leg squat in front of a mirror (no hanging on to anything).  See what happens to your knee.  Does it collapse in as you approach more than 30 to 45 degrees knee bend?  If so, imagine what happens to your knee when you load it when you run (which is essentially a repetitive, higher impact knee bend).

The answer initially includes VMO activation work and glute med strength and control work.  Once this can be achieved without body weight, then move on to body weight exercises, then exercises that increase the load (more weight, or no weight but involves steps ups or a jump....) and so on until you are ready to return to running.  Remember, running is a high impact activity.  It is not part of early rehab.  Find something else to do to maintain your CV fitness.  Swim, cycle, run in the pool....

ITB syndrome. A symptom, not the problem.