Iliotibial Band Syndrome
(IT Band Friction Syndrome; ITBFS; ITBS)
Iliotibial band syndrome (ITBS) is pain on the outside of the knee. The iliotibial (IT) band is a band of tissue that runs from the hip and attaches to the shinbone. Overuse can cause irritation.
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ITBS is caused by repetitive bending and extending of the knee. This can irritate the IT band and the tissue around it.
It may also be caused by structural problems, such as having a tight IT band.
This problem in more common in people who do activities with repetitive motions. Examples are running, cycling, rowing, soccer, and basketball. Other things that may raise the risk of ITBS are:
- Poor training methods, such as increasing mileage too quickly
- Running up and down hills or on surfaces that slope to one side
- Wearing damaged or worn shoes
- Muscle weaknesses in the legs and hips
- Structural problems, such as bowed legs or legs that are different lengths
Problems may be:
- Pain on the outside of the knee that happens during or after activity
- Burning on the outside of the knee that may spread to the thigh and hip
The doctor will ask about symptoms and health history. Questions will also be asked about your activities. A physical exam will be done. It will focus on the IT band. This is enough to make the diagnosis.
Pictures may be taken to confirm the diagnosis. This can be done with:
The goal is to ease pain and improve movement. This may be done with:
- Ice and rest to ease pain and swelling
- Medicine to ease pain and swelling
- Shoe inserts to help keep the knee stable
- Exercises to stretch and strengthen the IT band and leg muscles
Surgery may be done if other methods have not helped. Part of the IT band may be removed.
The risk of ITBS may be lowered by:
- Increasing activity levels slowly
- Using the right methods when playing sports
- Stretching and strengthening the IT band and leg muscles
- Wearing proper footwear
- Flato R, Passanante GJ, et al. The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skeletal Radiol. 2017 May;46(5):605-622.
- Iliotibial band (ITB) syndrome. EBSCO DynaMed website. https://www.dynamed.com/condition/iliotibial-band-itb-syndrome.
- Iliotibial band syndrome. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/21967-iliotibial-band-syndrome.
- Teresa Briedwell, PT, DPT, OCS, CSCS
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