Coping with ITB


Coping with ITB injuries


An ITB injury is a common cause of pain on the outside of the knee and normally occurs in runners. It is believed to result from constant friction of the ilio-tibial band sliding over the lateral femoral epicondyle (bony prominence) of the femur when the leg moves back and forth.

What is the ilio-tibial band?

It is a continuation of the tendonous portion of the TFL (tensor facia lata) which is a muscle that runs down the outside of the leg that moves the thigh outwards and towards the abdomen. The function of the ITB is to stabilise the knee and help with movement of the thigh and hip. The ITB inserts into the outside of the knee which is where the pain is felt.


How the pain starts:

The ITB moves forward as the knee extends and moves back as the knee flexes. Friction occurs when the knee flexes at a 30 degree angle. This continuous friction results in irritation and inflammation.

Causes of ITB injuries

Too much exercise too soon (sudden increased hill training or increased distance.)

Changes in running surfaces.

Unsuitable or old shoes.

Faulty biomachanics of the body eg, excessive pronation of the feet, leg length inequality, weak hip abductors etc.

Running on the camber of the road.

Treatment of ITB injuries

ACUTE: rest, ice, massage and anti-inflammatories.

SUB- ACUTE: Include stretches when inflammation has subsided and later add strengthening exercises.



Camelot international sports massage manual (2013), page 192


What you need to know about ankle sprains


What you need to know about ankle sprains


To properly treat an ankle sprain it must be determined that the ankle is indeed sprained, and this requires an understanding of the condition.

What is an ankle sprain?

An ankle sprain is a common injury and usually results when the ankle is twisted or turned (inverted). The term sprain signifies injury to the soft tissues (usually ligaments) of the ankle.

What is a ligament?

It is a tough band of tissue that helps connect bones together. The specific ankle ligaments that are affected are the anterior talofibular, posterior talofibular and calcaneofibular ligaments. The inward movement of the ankle results in a stretching and tearing of the anterior talofibular and calcaneofibular ligaments. These two ligaments prevent the ankle moving forward or inwards.

Degrees of ankle sprains

A minor sprain is an over-stretch of the ligament/s and tenderness will result.

Next would be a partial tear of the ligament/s which can result in minimal bruising and swelling.

The last degree is a complete tear of one or more ligaments which will result in an inability to place weight on the ankle as well as acute bruising and swelling.

There is a condition which is the most severe form of an ankle sprain which is called ankle syndesmosis and it involves damage to the other supporting ligaments of the ankle and leg (shin area). This injury takes very long to heal.


Swelling, pain and bruising is to be expected. Swelling is a result of ruptured blood vessels and most of the initial swelling is blood leaking into the surrounding tissues. Continued swelling is a result of lymphatic fluid collecting in the area.


Protection of the ankle via a brace or bandages while the ligaments heal.

Resting of the injured ankle is very important.

Ice can be placed on the ankle to decrease swelling and speed up healing.

Compression on the ankle must be applied as soon as possible to decrease swelling.

Elevate the ankle to reduce swelling.

Exercise the ankle once it has healed to prevent repeated injury.


Camelot international sports massage manual (2013)


How to cope with an injury


You have injured your muscle… now what?

Classify your injury

First degree muscle strain:

Excessive stretching or minor tearing of a few muscle fibres. Locialised pain with some stiffness and weakness.

Treatment: Rest, ice, compression (stocking/bandage) elevation, gentle stretching and pain-free exercise, progressing slowly back to normal exercise. Avoid sudden stop-starting types of exercise, eg. soccer.

Second degree muscle strain.

Moderate tearing of fibres with more generalised pain. Haemotoma (bruising) may occur due to bleeding and limping may result. See a medical practitioner.

Treatment: Same as above but progression should be slowed and recovery will take longer (2-3weeks)

Third degree muscle strain

A complete muscle tear with widespread bruising. This is a rare occurance. See your doctor immediately.

Treatment: Same as above but with extended rest time. 4-6 weeks to heal and walking aids may be required.

Understand what caused your injury

Most injuries are caused by the following:

Poor warm-up and fatigue.

A previous injury – injuries tend to recur in areas that have previously been injured.

Strength imbalance – Injured clients often have a strength imbalance within their muscles (one muscle is stronger than the other). This results in uneven contraction and the weaker muscle will often become injured.

Poor flexibility – When activities result in the muscles stretching beyond their normal range.

How to treat your injury -explained in detail

Rest: Once you realise that you are injured, stop immediately. You must cease the activity that caused the injury for some time afterwards. Do NOT exercise the injured part of your body or “work through the pain” this will only result in further injury. Only pain-free movements are allowed during exercise. If fitness maintenance is essential, then swimming is the best form of exercise, as no weight is carried.

Ice: This reduces swelling and inflammation. It is important to apply ice do as soon as possible after the injury. This treatment should be continued for two to three days.

Compression : Use a bandage, tape or brace to keep the area supported. This will reduce pain, swelling, bleeding and inflammation.

Elevate: Lift the injured area above the line of your heart. This will help with drainage and improve healing.

Rehabilitation: Stretch and strengthen the injured area once pain is reduced. Introduce stretching slowly and strengthening even slower.


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Source: Camelot International sports massage manual (2013) pg.202.