IT Band Syndrome

IT band syndrome or iliotibial band syndrome is an irritation of tissues near the attachment of the iliotibial band at the knee. This is an overuse condition that is very common in runners and cyclists. (1) The IT band conducts forces that are generated by the glutes and lateral hip down the entire length of the thigh. IT band syndrome comes from either compression of a highly innervated fat pad or strain on the attachment near the knee. (2) IT band syndrome is common in individuals who undergo repetitive knee flexion and extension such as runners, cyclists, weight lifters, and soccer, basketball, field hockey and competitive rowing athletes. Risk factors for the development of IT band syndrome include high mileage running, running on a circular track, and weakness of the knee extensors, flexors or around the hip. 

Typically individuals with IT band syndrome feel a sharp or burning pain on the outside of the knee. This is provoked by activity that requires repetitive knee flexion and extension. Over time, symptoms become more persistent and continue outside of activity. 

Treatment consists of increasing the mobility of the tissues connecting to the iliotibial band and strengthening the muscles around the knee and hip. Foam rolling, stretching, needling, or instrument assisted soft tissue mobilization all have positive effects for increasing the mobility of tissues in the area. Exercises often consist of working both the stabilization of the hip as well as its dynamic capacity. Activity modification often takes place at the beginning of treatment in an effort to reduce the load. Athletes running on a track should change the direction they are running with each mile to alter the load. As treatment progresses activity can be ramped back up as symptoms allow. 

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  1. Messier SP, Edwards DG, Martin DF, Lowery RB, Cannon DW, James MK, Curl WW, Read HM, Hunter DM> Etiology of iliotibial band friction syndrome in distance runners. Medicine and science in sports and exercise. 1995 Jan 1;27(7)951-60

  2. Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Philips N, Best TM, Benjamin M. The functional anatomy of the iliotibial band during flexion and extension of the knee. Implications for understanding iliotibial band syndrome. Journal of anatomy. 2006 Mar;208(3):309-16