Form Osteopathy

Form Osteopathy Osteopathy, dry needling and exercise rehabilitation for spinal pain, headaches and sporting injury.

23/04/2026

🏃‍♀️Running biomechanics: narrow step width 🏃‍♀️

Another behaviour commonly seen is a narrow step width (also known as cross-over gait).

This is observed from behind a runner (coronal view) and is when half (or more) of the foot striking the ground crosses over the body’s midline.

Although in part a foot placement strategy, a 2015 study showed that a narrow step width is correlated with overstriding.

Overstriding also plays a role in the increased hip adduction that we often see in conjunction with a pelvic drop (Trendelenburg’s sign) and reduced knee window (dynamic valgus).

It is not solely what happens at the knee, but what we observe happening above (proximal) and below (distal) the knee joint during the stance phase that impacts mechanical stress at the ITB insertion.

The most important thing to note with overstriding, hip drop, knee valgus and a narrow step width is that strength training alone does not resolve any of these behaviours.

Strength is important, yes. However, these are motor control issues and rely on feedback and re-training to improve.

21/04/2026

🦵Running biomechanics: overstriding🦵

Overstriding involves ‘overshooting’ the ideal landing position of the foot relative to our centre of mass.

What this looks like is a leg that lands with the knee in too much extension, such that the tibia is not in a vertical position upon impact.

There is plenty of research to indicate that this is a common factor contributing to running-related injuries.

Striding correlates with running cadence i.e. the number of steps taken per minute.

To limit the tendency to overstride it is best to think ‘run with more steps’, otherwise known as a higher cadence.

This will bring your centre of mass and the landing position of the foot closer together.

The effect is that the foot, knee and hip will all be in an efficient position to absorb kinetic energy and produce forces for push-off.

This may feel like it will slow you down because you are not pushing off with as much effort on each stride, however a high running cadence will also improve your running efficiency and overall performance, once you get the hang of it.

Of course, you will need to have your cadence measured and correlated with the pace you are running at before any adjustments are made.

14/04/2026

🏃‍♂️ The running biomechanics associated with ITB syndrome 🏃‍♂️

Though the primary issue with ITB syndrome is load magnitude, it is also helpful to evaluate contributing factors due to running biomechanics.

The main consideration when evaluating strain on the ITB during running is what happens when our feet contact the ground (stance phase). This includes not just the feet, but the knee, hip and spine. This is when the most kinetic energy is being absorbed.

A few running gait behaviours can increase strain on the ITB during the stance phase. They often occur together but we will explain them separately over our next few posts…

09/04/2026

👨‍⚕️ What we look for when assessing for ITB syndrome 👨‍⚕️

Investigation into current exercise activity is very important. We want to understand your run history, particularly the overall run volume, downhill running, recent addition of speed work and running on trails.

Other training factors to consider include terrain, incline, speeds, fatigue and surfaces.

*Load magnitude is far more important than training volume itself.*

We also want to understand how the pain occurs. There is no single diagnostic test to confirm ITB syndrome, but pain is likely reproduced with running (sharp and severe in quality) and descending stairs.

We can however perform some provocative tests to help understand the pain. These include:

🔹Forward step down: this eccentrically loads the ITB and is likely to cause pain.
🔹Decline squat (on a calf board): this test helps to differentiate between patellofemoral joint syndrome (PFJS) and ITB. This test will likely be more painful if experiencing PFJS.
🔹Noble compression test: reproduction of pain at 30 degrees of flexion.

07/04/2026

🏃‍♀️The mechanisms of injury for ITB syndrome🏃‍♀️

ITB syndrome occurs when the highly innervated adipose tissue deep below the ITB is compressed. The ITB itself is not highly innervated but the tissue below it is.

This occurs when the ITB is overloaded. The ITB is most loaded with:

🔹Eccentric TFL contractions: i.e. hip extension and knee flexion, particularly when running fast or running downhill.
🔹When varus loads are high: such as the stance leg in downhill running, narrow step width when trail running or running on a slanted surface.

The ITB is loaded least when:

🔹Running uphill: i.e. concentric work is greater than eccentric work.
🔹Walking uphill
🔹Stance leg running uphill

The key is to be careful with high eccentric loads.

Our clinic will be closed tomorrow, 3rd April, for the Easter long weekend and will reopen Tuesday 7th April.We wish you...
02/04/2026

Our clinic will be closed tomorrow, 3rd April, for the Easter long weekend and will reopen Tuesday 7th April.

We wish you a wonderful Easter with friends and family!

31/03/2026

The goblet squat is a great exercise to add to your lower body workout as it combines lower-body strengthening with core stability and movement quality.

It is a compound movement, meaning it trains multiple muscle groups simultaneously, such as the glutes and quads.

Holding the weight in front of the chest when performing this squat variation creates a front-loaded position, forcing the core to stabilise your body.

It can also be more spine-friendly than traditional back squats as the front-positioned load acts as a counterbalance, although you aren’t able to progress in weight to the extent that you can with a back squat.

We often recommend goblet squats for beginners, people with lower back pain or in a rehabilitation setting.

💥 Risk factors (and those NOT considered to be risk factors) for ITB syndrome 💥Risk factors:🔷 Training errors🔷 Training ...
26/03/2026

💥 Risk factors (and those NOT considered to be risk factors) for ITB syndrome 💥

Risk factors:

🔷 Training errors
🔷 Training load
🔷 Running biomechanics

NOT risk factors:

🔷 Failing to stretch
🔷 Leg length discrepancies
🔷 Positive Ober’s test: an examination to test tightness in the ITB and TFL muscle.
🔷 Foot pronation
🔷 Hip weakness
🔷 Weak hip abductors: weak hip abductors do not increase the risk factor for ITB syndrome despite their relationship to the ITB.
🔷 A tight ITB is not a risk factor: a compliant ITB results in a compromised ability to store and release energy, and resist varus knee torque.
🔷 Shear wave elastography: ultrasound imaging that quantifies tissue stiffness. Note: the stiffness of the ITB does not contribute to ITB syndrome.

Study: Etiology of iliotibial band friction syndrome in distance runners" - Messier S P 1995

25/03/2026

🛑 ITB syndrome: symptoms to watch out for 🛑

Although very common in runners, ITB syndrome is the most common cause of lateral knee pain so it should also be considered in cases of non-runners too.

The main symptom of ITB syndrome is pain at 25 – 30 degrees of knee flexion (either moving in or out of flexion).

It is common in inexperienced runners who are completing a high weekly mileage or in a rapid increase in downhill running, speed work and overall distance running (such as trail running).

🏃 What is the function of the ITB? 🏃The ITB is essential for elastic energy storage and release. It’s a vital structure ...
19/03/2026

🏃 What is the function of the ITB? 🏃

The ITB is essential for elastic energy storage and release. It’s a vital structure for stabilising the pelvis during movement.

The ITB stores 5 – 14% of total work during running. In comparison, the Achilles tendon stores and releases 35% of energy during running.

The ITB is an important frontal plane stabiliser for the body. It stabilises against varus (outward pointing) knee torque and the patella (knee cap) against medial dislocation.

🦵The anatomy of the ITB 🦵Many people are aware that the ITB runs along the outside of their thigh but might be surprised...
17/03/2026

🦵The anatomy of the ITB 🦵

Many people are aware that the ITB runs along the outside of their thigh but might be surprised to learn it’s a connective tissue and not a muscle.

ITB stands for iliotibial band i.e. ilio = pelvis and tibial = shin bone.

It begins at the pelvis, connecting to the fibres of the gluteus maximus and the TFL muscle (a small muscle located on the outer hip).

It runs down along the outside of the thigh and inserts at the proximal tibia (the upper widened end of the shin bone) at a site referred to as Gerdy’s tubercle, which is a smooth bony projection 2-3cm below the knee joint.

The ITB is firmly attached to the whole length of the femur through fascial connections, though as it has no direct bony attachment to the femur, the ITB can shift anterior or posterior (front to back) as your knee flexes and extends.

❓Did you know? ❓

Fact: ITB is not present at birth but develops when we start walking as a baby or toddler.

Are you a runner? 🏃 Then you might want to listen up.ITB syndrome is a common condition experienced by runners of all le...
12/03/2026

Are you a runner? 🏃 Then you might want to listen up.

ITB syndrome is a common condition experienced by runners of all levels (even non-runners too!) that takes patience and diligence to see healed.

Previously, this condition was thought to be caused by friction of the ITB rubbing over the outer knee. We now understand that the pain is more likely driven by compression of a highly pain-sensitive fat pad beneath the ITB band, particularly when loads exceed the tissue’s capacity.

When assessing lateral knee pain and addressing ITB syndrome, the primary thing to look at is load magnitude and running biomechanics.

ITB syndrome can be frustrating. It rarely settles quickly and often requires careful load modification, progressive strengthening and patience to achieve lasting improvement.

This month we’re going to explore the anatomy of the iliotibial band and its relationship to the knee, its role, common symptoms and mechanisms of injury, risk factors and strategies to help you recover and return to activity.

Stay tuned! More to come…

Address

91 Upton Street
Bundall, QLD
4217

Opening Hours

Monday 9am - 5pm
Tuesday 9am - 5pm
Wednesday 9am - 5pm
Thursday 9am - 5pm
Friday 9am - 5pm

Telephone

+61755316422

Website

Alerts

Be the first to know and let us send you an email when Form Osteopathy posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Practice

Send a message to Form Osteopathy:

Shortcuts

Share

Category