What Is Iliotibial Band Syndrome?
ITBS cause pain along the outside of the knee
By Elizabeth Quinn, About.com Guide
Updated September 27, 2011
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
IT Band runs along the outside of the thigh
Photo © Wikimedia Commons
Iliotibial band friction syndrome is a common cause of knee and hip pain in athletes. Knee pain
from this injury is most commonly felt along the outside (lateral) knee and the lower thigh. IT
band syndrome may also result in a nagging or acute pain on the outside of the hip.
What's the Iliotibial Band?
The iliotibial band is a strong, thick band of fibrous tissue that runs along the outside of the
leg. The IT band starts at the hip and runs along the outer thigh and attaches on the outside
edge of the shin bone (tibia) just below the knee joint. The band works with the quadriceps
(thigh muscles) to provide stability to the outside of the knee joint during movement.
What Causes Iliotibial Band Pain?
Iliotibial band syndrome is typically caused by inflammation of the iliotibial band. IT band
syndrome is a common injury in runners or other athletes that run for training or during their
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sports. The IT band acts primarily as a stabilizer during running and may become irritated from
overuse. The pain is typically felt on the outside (lateral) aspect of the knee or lower thigh, but
may be felt near the hip, and is often more intense when descending stairs, or getting up from
a seated position.
Common Causes of IT Band Syndrome
Overuse
Increasing Training Too Quickly
 Overtraining Syndrome
Returning from Injury Too Soon
 Faulty Biomechanics
 Other Training Errors
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IT band syndrome is common in runners who perform unbalanced, repetitive exercise such as
running only on one side of a crowned road, or only running one way around a track. Most
roads slope off to the sides and running along the edge causes to the outside foot to be lower
than the inside foot. This in turn causes the pelvis to tilt to one side and stresses the IT band.
The biomechanical abnormalities that may lead to IT band problems include: excessive
pronation of the foot, leg length discrepancy, lateral pelvic tilt, and "bowed" legs. Muscle
tightness or lack of flexibility in the gluteal (buttock) or quadriceps (thigh) muscles may
increase the risk of IT band injuries. Sports physical therapists often use video tape analysis to
uncover any biomechanical problems and make corrections in technique or muscle weakness
or tightness.
How is IT Band Syndrome Treated?
Treating IT band friction syndrome generally includes:
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R.I.C.E.: Rest, ice, compression and elevation is the best way to treat initial IT band pain.
Physical Therapy. A therapist may use ultrasound and other modalities to help the injured
tissues heal more quickly. A skilled PT can also help you correct any biomechanical or
training errors, and teach you how to perform the right flexibility exercises.
Reduced Activity. Runners with IT band pain should reduce running mileage and be alert for
signs of overtraining syndrome.
Foam Roller Myofacial Release. Using a foam roller to release the tissues may be painful, but
many athletes have excellent success with this technique.
 Anti-inflammatory medications may also be used to reduce pain and inflammation.
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Rest and Recovery is an important part of your recovery and should be maintained as part of
a balanced training program.
How to Prevent IT Band Syndrome
The following tips may help you prevent chronic IT band syndrome:
If you are a runner, first review the Checklist for Running Overuse Injuries
 IT Band - Strengthening Exercises
Strengthening the external hip rotators may also help reduce the risk of IT Band injuries. One
simple way to do this is with the one-leg squat exercise. Perform these in front of a mirror
and make sure your pelvis does not drop on one side during the reps.
 One-Leg Squat Exercise
IT Band - Stretching Exercises
Stretching the IT band may help prevent irritation from IT band tightness.
 Standing IT Band Stretch
 Advanced IT Band Stretch for IT Band Pain
 Crossover Squat Stretch
 Foam Roller Exercises to Stretch the IT Band
Use the Right Shoes
Consider Using Orthotics or Shoes Inserts
Replace Running Shoes
Avoid Overtraining
Cross Train
Get Adequate Rest and Recovery
Try Backwards Running to correct muscle imbalance and reduce pressure on the knees.
Run on a soft, level surface or alternate directions on the road.
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IT Band Friction Syndrome doesn't have to be a chronic, debilitating problem. A little bit of
prevention and careful diagnosis of the cause can lead to a complete and full recovery.
Source: R Khaund, M.D. and S Flynn, M.D., Iliotibial Band Syndrome: A Common Source of Knee Pain, the American Academy of Family Physicians, April 15, 2005.
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