by EBSCO Medical Review Board
(IT Band Friction Syndrome; ITBFS; ITBS)

Definition

Iliotibial band syndrome (ITBS) is pain on the outside of the knee. The iliotibial (IT) band is a band of tissue that runs from the hip and attaches to the shinbone. Overuse can cause irritation.

Tendons of the Lateral Knee
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Causes

ITBS is caused by repetitive bending and extending of the knee. This can irritate the IT band the tissue around it.

It may also be caused by structural problems, such as having a tight IT band.

Risk Factors

This problem in more common in people who do activities with repetitive motions. Examples are running, cycling, rowing, soccer, and basketball. Other things that may raise the risk of ITBS are:

  • Poor training techniques, such as increasing mileage too quickly
  • Running up and down hills or on surfaces that slope to one side
  • Wearing damaged or worn shoes
  • Muscle weaknesses in the legs and hips
  • Structural problems, such as bowed legs or legs that are different lengths

Symptoms

Problems may be:

  • Pain on the outside of the knee that happens during or after activity
  • Burning on the outside of the knee that may spread to the thigh and hip

Diagnosis

The doctor will ask about your symptoms, health history, and the activities that you do. A physical exam will be done. It will focus on your IT band. This is enough to make the diagnosis.

Images may be taken to confirm the diagnosis. This can be done with:

Treatment

The goal is to ease pain and improve movement. This may be done with:

  • Ice and rest to ease pain and swelling
  • Medicine to ease pain and swelling
  • Shoe inserts to help keep the knee stable
  • Exercises to stretch and strengthen the IT band and leg muscles

Surgery may be done if other methods have not helped. Part of the IT band may be removed.

Prevention

The risk of ITBS may be lowered by:

  • Increasing activity levels slowly
  • Using the right techniques when playing sports
  • Stretching and strengthening the IT band and leg muscles
  • Wearing proper footwear

RESOURCES

American College of Sports Medicine  http://acsm.org 

OrthoInfo—American Academy of Orthopaedic Surgeons  http://orthoinfo.org 

CANADIAN RESOURCES

Canadian Orthopaedic Association  http://www.coa-aco.org 

Department of Orthopaedics—The University of British Columbia  http://www.orthosurgery.ubc.ca 

References

Flato R, Passanante GJ, et al. The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skeletal Radiol. 2017 May;46(5):605-622.

Iliotibial band (ITB) syndrome. EBSCO DynaMed website.  https://www.dynamed.com/condition/iliotibial-band-itb-syndrome  . Updated March 24, 2016. Accessed March 26, 2020.

Iliotibial band syndrome. https://www.cedars-sinai.org/health-library/diseases-and-conditions/i/iliotibial-band-syndrome.html . Accessed March 26, 2020.

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