IT Band Syndrome

What Is IT Band Syndrome?

Iliotibial band syndrome (ITBS) is an overuse injury causing pain on the outer side of the knee. The IT band is a thick band of tissue running from the hip to below the knee, and irritation occurs where it crosses the knee joint.¹

Symptoms

Sharp or burning pain on outer knee
Pain typically worse with running/cycling
Pain often starts after certain distance/time
Worse going downhill or down stairs
May feel snapping over knee
Tender to touch at outer knee

Risk Factors²

Running (esp. distance)
Cycling
Sudden increase in training
Running on banked surfaces
Weak hip abductors
Leg length discrepancy
Excessive foot pronation

Diagnosis

Clinical examination
Noble compression test
Ober test for IT band tightness
MRI if diagnosis unclear

Treatment³

Acute Phase

Reduce or stop aggravating activity
Ice
NSAIDs

Rehabilitation

Hip abductor strengthening (key!)
Glute strengthening
Foam rolling (some benefit)
IT band stretching
Gait analysis/modification

Other Options

Corticosteroid injection
PRP
Surgery (rare, last resort)

References

Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35(5):451-459.
Noehren B, Davis I, Hamill J. ASB clinical biomechanics award winner: prospective study of the biomechanical factors associated with iliotibial band syndrome. Clin Biomech. 2007;22(9):951-956.
Beers A, Ryan M, Kasubuchi Z, et al. Effects of multi-modal physiotherapy on hip abductor strength and pain in runners with ITB syndrome. Phys Ther Sport. 2008;9(2):57-65.