What Is Iliotibial Band Syndrome and How Can You Treat It?

ITBS cause pain along the outside of the knee

IT Band pain in athletes
IT Band pain in athletes. Jordan Siemens/Iconica/Getty Images

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 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

  • Faulty Biomechanics
  • Other Training Errors

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:

  • 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.

How to Prevent IT Band Syndrome

The following tips may help you prevent chronic IT band syndrome:

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.


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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