What is IT Band Syndrome?

By Rich Dowd OMSII

Iliotibial band syndrome, more commonly referred to as IT band syndrome, is a common overuse injury of the IT band – the sheath of connective tissue that spans the outside of the thigh. Though the IT band spans from the hip to just below the knee, it almost always presents as localized pain along the outside of the knee. It is more common in active individuals and runners, in particular, are at greater risk of developing IT band syndrome.

What causes IT Band Syndrome?

IT band syndrome is typically caused by repetitive flexion/extension of the knee (ie running) which causes the IT band to rub against the lateral femoral epicondyle (the outer bony projection of the knee). This repetitive rubbing between the IT band and the knee may result in irritation and ultimately inflammation.

Risk factors include:

  • High weekly mileage
  • Downhill running
  • Excessive running on a banked track
  • Weak gluteal muscles

What are the symptoms of IT band syndrome?

The most commonly presenting symptoms of IT band syndrome include:

  • Pain along the outside of the knee
  • Mild swelling
  • Pain with twisting of the knee
  • Occasional pain closer to the hip

How is IT band syndrome diagnosed?

IT band syndrome can usually be diagnosed based on history and the clinical presentation of the patient. There will be tenderness to palpation along the IT band, particularly around the outside aspect of the knee. It may present similarly to a lateral meniscus tear, however, a lateral meniscus tear will typically have considerably more swelling than that seen in IT band syndrome. Furthermore, you will usually experience a “click” mid-stride with a tear which will not be present in IT band syndrome. An MRI may be ordered to rule out lateral meniscus tear and confirm the diagnosis of IT band syndrome.

How is IT band syndrome treated?

IT band syndrome must be managed properly in order to prevent a chronic recurring injury. The first thing one should do is stop the activity that exacerbates the pain (ie running). You may remain active by trying other activities that don’t elicit the same knee pain, such as swimming. In addition to activity modification, the following treatments may help IT band syndrome:

  • Stretching
  • Nonsteroidal anti-inflammatories (such as Ibuprofen) as needed
  • Ice
  • Physical therapy
  • Foam rolling the lateral aspect of the knee/thigh (a ball may be substituted for a foam roller)

In addition to the measures taken above, a cortisone injection may help to reduce inflammation and pain. Surgical release of the IT band has been shown to alleviate IT band syndrome and is a viable option after the aforementioned measures have been attempted.

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