Iliotibial band syndrome (ITBS) is an overuse injury. The iliotibial band (ITB) is a thick band of fibrous tissue. It runs from the hip down the outside of the thigh and attaches to the tibia. The tibia is the large bone of the lower leg.
Tendons of the Lateral Knee
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ITBS is caused by repetitive friction or rubbing of the iliotibial band against the bone on the outer side of the knee. This excessive rubbing can irritate the ITB and/or the tissue underneath.
Causes of the excessive friction include: Structural abnormalities, such as a short, tight IT bandProblems related to the foot, ankle, or hipOpposing muscle imbalances, such as the quadriceps stronger than hamstrings or weak gluteal musclesA prominent lateral femoral epicondyle, the bony structure on the outer side of the kneeInward rotation of the legAngle where knee flexesLegs of different lengthsBowlegs
Factors that increase your risk of getting ITBS include: Certain sports with repetitive motions, such as running and cyclingIncorrect training techniqueIncreasing cycling or running mileage too quicklyRunning up and down hillsOvertrainingUsing damaged or worn out equipment or footwearWearing improper shoes for a sport or athletic activityAthletic equipment that is not properly fit to the user, such as a bicycle
Symptoms of ITBS include: Dull aching or burning sensation on the outside of the knee during or after activitySharp stabbing pain on the outside of the knee during or after activityPain that shows up in the hip, known as referred painProgressive, worsening painSnapping, creaking, or popping when the knee is bent and then straightened
You will be asked about your symptoms and medical history. In most cases, diagnosis can be made with a physical exam.
Your ITB function may be tested. This can be done with: Ober test—determines the tightness of the ITBRennes test—specifies the area of pain while full weight is placed on the bent legNobles test—determines the area of pain while the leg is flexed at a certain angle
Images may be needed of your leg. This can be done with an
Talk with your doctor about the best treatment plan for you. Recovery time ranges depending on the grade of your injury. Treatment steps may include:
The IT band will need time to heal. Supportive care may include: Rest—Activities may need to be restricted. Normal activities will be gradually reintroduced as the injury heals. Ice—Ice therapy may help relieve swelling. Heat therapy may be advised when normal activities are reintroduced. An orthotic device may be advised to help control rotation of the foot and stabilize the knee.
Prescription or over-the-counter medications may be advised to reduce pain. Corticosteroid injections may also be advised in some cases.
A physical therapist will assess the IT band. An exercise program will be created to help recovery and to stretch and strengthen the muscles.
Surgery may be needed in cases when other treatments are not effective.
To reduce your chances of ITBS, take these steps: Learn proper training techniques.Increase mileage from running gradually.Wear appropriate shoes for each sport.Replace athletic shoes as they show signs of wear.Be aware of running surfaces.Use properly fitted equipment.Strengthen your quadriceps, hamstrings, and gluteal muscles.
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Iliotibial band (ITB) syndrome.
http://www.ebscohost.com/dynamed. Updated July 10, 2013. Accessed February 29, 2016.
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J Am Acad Orthop Surg. 2011 Dec;19(12):728-36.
Last reviewed February 2016 by Teresa Briedwell, PT, DPT, OCS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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