What is Iliotibial Band Syndrome?

Iliotibial band syndrome (also commonly referred to as ITBS or IT band syndrome) is an overuse condition affecting the iliotibial tendon, the connective tissue running along the outside of the hip to the outside of the knee. This injury causes the IT band to become inflamed, causing pain, usually on the outside of the knee.

Because IT band syndrome can interfere with training, daily movement, and in some cases even walking, early diagnosis and the right treatment matter.

Anatomy Related to Iliotibial Band Syndrome

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: When these muscles are weak, the IT band can take the strain.

What Causes IT Band Syndrome (ITBS)?

Iliotibial band syndrome occurs when the iliotibial band becomes irritated by friction against the knee, thigh, or hip bones. Some experts also believe that the inflamed IT band causes compressive forces to push down on the fat pad below, causing pain.

Iliotibial band friction syndrome is typically caused by repetitive knee bending during high-repetition sports such as long-distance running, cycling, hiking, and rowing.

Experts estimate ITBS accounts for about 12% of all running injuries and is more common in long-distance runners. Some causes of ITBS in runners are:

• Overtraining
• Sudden spikes in training load without allowing proper time to adapt
• Unsupportive running shoes
• Running on uneven surfaces, banked tracks, or steeply sloped downhill terrain
• Having a high weekly mileage
• Downhill running
• Anatomical misalignments such as bowed legs, leg-length differences, or excessive inward foot rolling
• Weak hip abductors and gluteal muscles may force the IT band to overcompensate to stabilize the leg.

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 is 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 lying 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 cause the knee pain.

Some treatment methods used to heal IT band syndrome are:

• Resting
• Stretching
• Non-steroid anti-inflammatory drugs (NSAIDS), such as ibuprofen
• Icing the area
• Physical therapy
• Corticosteroids

If the pain still exists after a few weeks of using recovery methods, it would be good to see a physical therapist to 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 recurring 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
• Avoid 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 the IT band

IT Band Syndrome Treatment in Ohio

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! Our offices are found in various locations throughout Columbus, Ohio.