ILIO-TIBIAL BAND SYNDROME

The IT band is a thickening of connective tissue on the outermost or lateral part of the thigh. It contributes to the stability of both the hip and knee. It is, therefore, quite prone to injury. IT Band Syndrome (“ITBS”) is common upon runner and cyclists. Stud-ies have shown that it is the most common running injury of the lateral part of the knee as well as 22% of all lower extremity injuries. Patients feel pain and tenderness in the knee caused by repetitive flexion of the joint. The IT band rubs against the part of the femur attached to the knee, causing friction and inflammation. This pain and discomfort often causes gait (walking) abnormalities.


There are several common mechanisms of injury for IT Band Syndrome. For ex-ample, weak hip abductor muscles, or the muscles that move the thigh outward to the side, will cause too much hip adduction, or the movement of the thigh toward the mid-line of the body. This occurs when the foot hits the ground while running. Many runners also over-pronate, or turn the ankle inward, which causes increased stress on the IT band. Other factors include increased knee flexion during downhill running or fatigue at the end of a run, too much internal rotation of the knee, and low hamstring strength when compared to quadriceps strength.

Few patients require surgical care, although removal of a cyst deep to the band may be necessary in some cases. But have no fear; there are several conservative treatment plans for IT Band Syndrome. First, limit your mode of activity. Relieve pain and inflammation with ice or anti-inflammatory agents, such as a corticosteroid or NSAID drug. Stretch the IT band by placing the affected leg behind the other while standing and stretching sideways away from the affected side. Finally, ask your doctor about orthotics, especially if you have over-pronation. Occasionally, an injection of local anesthetic and steroid (cortisone) will help in reducing the inflammation.



Try to improve your ‘gait’ by stretching, wearing the right type of running shoes and using orthoses when needed. Remember, your orthoses should be fitted by a pro-fessional (physician) much like a pair of prescription glasses. Avoid stores where you stand on a mat or where your foot is scanned – in those cases a ‘physician’ is not evaluating your gait cycle.





Lavine, Ronald. “Iliotibial Band Friction Syndrome.” Current Reviews in Musculoskeletal Medicine Vol 3 No 1-4 (2010): 18-22.