Iliotibial Band Syndrome: What is It and Why You Should Care

Posted by Filed Under: Running Injuries

phsyiologically speaking1. What is it?

The iliotibial band (ITB) is a sheet of fibrous tissue that extends from the outside of the hip, down the outer thigh to the outside of the knee. The ITB helps to stabilize the knee joint. During normal movement, as the knee bends and straightens, the ITB rubs over part of the femur. If the rubbing is excessive, injury occurs.

2. What are the causes/predisposing factors of injury?

Intrinsic factors leading to injury may include: misalignment of the feet, knees, pelvis or hips, leg length differences, high arches and bowed legs. Other contributing factors can include: worn out shoes, running on crowned roads, excessive increases in mileage and or speedwork.

3. What are the symptoms?

Sharp pain that is felt on the outside portion of the knee that may radiate up the outside of the thigh is the usual presentation. Movements such as going up and down stairs, squatting or sitting with the leg crossed may aggravate the condition. This problem can be very persistent and last many months or longer.

4. What can be done to prevent or treat this condition?

Prevention focuses on reducing the predisposing factors mentioned above. For example: overpronators should consider motion control shoes, those with excessively high arches should be in cushioned shoes. A program that enhances the strength and flexibility of the hip abductor muscles (gluteus medius and tensor fascia latae muscles) is also recommended.

Treatment of ITBS is multi-faceted. Reducing training intensity and volume, running on flat terrain and avoiding downhill running may all help. Doing non-impact cardio if the symptoms are severe is another good alternative.

Physical therapeutics, NSAIDS (non-steroidal anti-inflammatory drugs), soft tissue therapy, joint manipulation and rehabilitation exercise all play a role in treating ITBS. In severe cases however, surgery may be required to release the ITB if conservative means are unsuccessful.

A worse case scenario may see chronic ITBS leading to a knee problem by causing improper patellar alignment. What can result is a deterioration of the cartilage on the underside of the kneecap along with the pre existing ITBS.

(Update: Take a look at this video from about how to use a foam roller on your IT band.)

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  1. Funky Dung on March 8th at 7:02 am

    After about two months, I think I’ve finally licked this injury. I didn’t stop running or really reduce my training much. I took two ibuprofen before running and wore an adjustable stabilizing knee brace until I felt good enough to take just one ibuprofen and wear an IT band compression wrap. For the first month or so I also stretched my IT band before and multiple times during my workouts. I didn’t reduce the number of workouts or miles, per se, but I did cut runs short if the pain god bad.

    Just my two cents. Of course, your mileage may vary.

  2. Dr. Lee Miller D.C. on March 8th at 10:20 am

    I have mixed feelings about taking ibuprofen or aspirin prior to a workout. Pain is your bodys’ way of telling you to back off. Taking medication may blunt this warning signal, allowing more damage to occur. You have to be very cautious when using this approach. If you were taking sufficent dosage to act as an anti inflammatory- fine, but there still is the issue of masking the symptoms.

  3. Bill Gibbs on March 9th at 11:56 am

    Good article, short and to the point. You may want to include a brief anatomy lesson though. Too often people mistake the ASIS for the hip joint.

  4. Dr. Lee Miller D.C. on March 10th at 9:06 am

    Good idea Bill, however in the quest for brevity, I generally do not go into detail on the specific anatomy of an injury unless absolutely necessary. Most people can Google these specifics if they are so inclined. Thanks for the kind feedback though!

  5. Laura Thomas on March 18th at 12:21 pm

    I have heard that using an IT band wrap can help with symptom’s, but my doctor didn’t recommend it for me. Is the wrap just a gimick or does it really help?

  6. Dr. Lee Miller D.C. on March 26th at 4:17 pm

    I have not heard of using a wrap for ITB problems. I do believe there is a method of taping the ITB, but I have not heard of any results for this therapy.