IT Band Syndrome

Information About Iliotibial Band Syndrome and Treatments Available

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Iliotibial band syndrome, or ITBS, is the result of inflammation of the iliotibial band, a thick band of fibrous tissue that runs down the outside of the leg. The iliotibial band begins above the hip joint and extends to the outer side of the shin bone (tibia) just below the knee joint. The IT band functions in coordination with several of the thigh muscles to provide stability to the outside of the knee joint.

Iliotibial Band Syndrome

Iliotibial band syndrome (ITBS) occurs when there is irritation to this band of fibrous tissue. The irritation usually occurs at the prominence of the outside of the knee joint, the lateral condyle which is located at the end of the femur (thigh) bone. The iliotibial band crosses bone and muscle at this point; between these structures is a bursa which should facilitate a smooth gliding motion of the band. However, when inflamed, the iliotibial band does not glide easily, and pain associated with movement is the result.

Symptoms of ITBS

As stated previously, the function of the iliotibial band is both to provide stability to the knee and to assist in bending the knee joint. When irritated, movement of the knee joint becomes painful. Usually the pain worsens with repetitive movements, and resolves with rest.

Common symptoms of ITBS include:

  • Swelling at the location of discomfort
  • A snapping or popping sensation as the knee is bent

Endurance athletes are especially prone to developing iliotibial band syndrome. Athletes who suddenly increase their level of activity, such as runners who increase their mileage, often develop iliotibial band syndrome.

Treatment of ITBS

Treatment of iliotibial band syndrome begins with efforts to control the inflammation. The initial phase is:

  • Rest
    The first step to allowing inflammation to subside is to allow the joint to rest sufficiently. Athletes shoudl avoid activities that cause worsening of symptoms.  Often athletes can find a cross-training alternative activity that does not cause persistence of symptoms.
  • Ice
    Icing the area of discomfort can help to relieve the pain and settle the inflammation.  It is important to apply ice frequently and consistently.  Especially after activity, ice can help to minimize swelling.
  • Anti-inflammatory Medications
    Anti-inflammatory medications are frequently recommended to help relieve inflammation about the iliotibial band.  Before beginning any anti-inflammatory medication one should discuss with their healthcare provider the safety of these medications.

Once the acute symptoms are controlled, patients should make efforts to increase flexibility and strength of the hip and knee.

Most rehabilitation protocols focus on both hip and knee function, as the iliotibial band requires proper mechanics of both of these joints for normal function. Working with a physical therapist can help you ensure you are developing an appropriate treatment strategy. Runners, cyclists, and other endurance athletes should find cross-training techniques that allow maintenance of their endurance without continuation of their discomfort.

A cortisone injection into the area of inflammation may also be attempted, usually after these other treatments fail. In young athletes, however, most physicians agree that cortisone is probably not a good solution for IT band syndrome.  Certainly cortisone should not be injected so that young athletes can continue sports participation--in these situations, rest of the IT band needs to precede any injections.  If all else fails to relieve the discomfort of ITBS, surgery is an option, but only in very rare circumstances.  In these situations, the IT band can be surgically lengthened to allow less friction over the structures on the outside of the knee joint.


Fredericson M, Weir A. "Practical management of iliotibial band friction syndrome in runners" Clin J Sport Med. 2006 May;16(3):261-8.

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