What Is It?

Iliotibial band syndrome (also commonly referred to as ITBS or IT band syndrome) is a condition that occurs when the iliotibial tendon (connective tissue located along the outside of the hip to the outside of the knee) becomes inflamed due to overuse.

Iliotibial band syndrome can cause pain in the knee, make it difficult to move, and can sometimes even prevent you from walking. IT band syndrome is a condition that is typically associated with running and cycling injuries.

If you have pain in your knee and suspect that you might have IT band syndrome, then schedule a consultation with our expert orthopedic surgeons at OrthoNeuro. Our doctors offer accurate diagnoses and personalized treatment plans. 

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IT band syndrome involves many muscles, soft tissues, and bones in the lower part of the body. Some of the common structures involved in IT band syndrome are:

  • The iliotibial band (the connective tissue that runs along the outside of the thigh and connects to the knee.)
  • The bursa (a fluid-filled sac located between the bones and soft tissues that limits friction.)
  • The hip muscles

What Causes IT Band Syndrome (ITBS)?

Iliotibial band syndrome occurs when there is excessive irritation and friction between the Iliotibial band and the knee, thigh, and hip bones.

Iliotibial band friction syndrome is typically caused by the repetitive bending of the knee during physical activities such as running, cycling, hiking, and swimming.

ITBS is the cause of most running injuries and most commonly occurs among runners. Some causes of ITBS in runners are:

  • Unsupportive running shoes
  • Running on uneven surfaces
  • Weak core and gluteal muscles
  • Hip abductor weakness
  • Having a high weekly mileage
  • Downhill running

What Are the Symptoms of IT Band Syndrome?

Those who have ITBS usually experience pain in their knee joint. In most cases, people with ITBS think they have a knee injury when they first start experiencing pain.

However, knee injuries usually have swelling around the knee. A lack of swelling is one of the signs that the pain in your knee is caused by your iliotibial band instead of a knee injury.

The signs and symptoms of IT band syndrome are:

  • Pain on the outside of your knee
  • Difficulty with movement
  • Occasional hip pain
  • Pain when running or bending the knee
  • The knee being tender to the touch
  • Lingering pain in the knee after exercise
  • A clicking sensation that occurs when the IT band rubs against the knee
  • Tenderness in the buttocks (gluteus medius, gluteus maximus)

How Is Iliotibial Band Syndrome Diagnosed?

To accurately diagnose whether or not you have ITBS a healthcare professional will talk with you about your symptoms and your history of physical activity. They will ask you about when your pain began and what activities caused it.

Your doctor will most likely conduct physical examinations such as an “Ober test “. Ober tests involve the patient laying on their pain-free side while placing their knee and hip at a 90-degree angle. 

The doctor then lifts the injured leg and determines the level of tightness in the iliotibial band.

Your doctor might also order imaging tests such as an X-ray or an MRI to confirm the diagnosis.

Iliotibial Band Syndrome Treatment

IT band syndrome doesn’t usually take a long time to heal. An effective treatment strategy for ITBS is resting from the activities that caused the knee pain.

Some treatment methods used to heal IT band syndrome are:

  • Resting
  • Stretching
  • Anti-inflammatory medications (ibuprofen)
  • Icing the area
  • Physical therapy

If the pain still exists after a few weeks of using recovery methods, it would be good to see a physical therapist to additionally assist with recovery.

A physical therapist will aid you with stretching and strengthening exercises to strengthen your muscles and restore your range of motion.

How Can IT Band Syndrome Be Prevented?

ITBS is preventable, most athletes or other people with ITBS syndrome can return to their physical activity by making a few simple changes in their routine.

Some methods that can be used to prevent IT band syndrome from reoccurring include:

  • Wearing the proper footwear when engaging in physical activities such as running or cycling.
  • Maintaining the strength in your core, hip abductor muscles, and leg muscles
  • Avoiding running on uneven hills and/or surfaces
  • Taking adequate time to rest between periods of physical activity
  • Stretching regularly to prevent tightness in the hips, hamstrings, outer thigh, and the IT band
  • Regularly consulting a physical therapist or sports medicine specialist to maintain the flexibility and strength of the muscles and IT band


Our board-certified orthopedic and sports medicine specialists at OrthoNeuro have helped many patients with IT band syndrome return to an active and healthy lifestyle using a variety of treatment options.

If you have pain in your knee and would like to know if you have iliotibial band syndrome, Make an appointment for a physical examination with an OrthoNeuro specialist today!

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