Iliotibial band syndrome (ITBS) is an overuse injury. It happens in the soft tissues in the lower thigh, near the outside of the knee. The iliotibial band (ITB) is a thick band of fibrous tissue. It runs from the hip down the outside of the thigh and attaches to the tibia. The tibia is the large bone of the lower leg.
Treatment depends on the severity of the injury.
Tendons of the Lateral Knee
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ITBS is caused by repetitive friction or rubbing of the iliotibial band against the bone on the outer side of the knee. This excessive rubbing can irritate the ITB itself and/or the tissue underneath.
Causes of the excessive friction include:
Factors that increase your risk of getting ITBS include:
Symptoms of ITBS include:
Your doctor will ask about your symptoms and medical history. In most cases, diagnosis can be made with a physical exam.
Tests may include:
For images of the internal structure of your leg, your doctor may recommend an MRI.
Talk with your doctor about the best treatment plan for you. Recovery time ranges depending on the grade of your injury. Treatment steps may include:
Your IT band will need time to heal. Avoid activities that place extra stress on the knee:
Your doctor may recommend a foot orthotic to help control rototation of the foot. This will help stabilize the knee.
Apply an ice or a cold pack to the area for 15-20 minutes, four times a day, for several days after the injury. Do not apply the ice directly to your skin. Wrap the ice or cold pack in a towel.
To manage pain, your doctor may recommend:
Use heat only when you are returning to physical activity. Heat may then be used before stretching or getting ready to play sports to help loosen the muscle.
When the acute pain is gone, start gentle stretching as recommended. Stay within pain limits. Hold each stretch for about 10 seconds and repeat six times. Stretch several times a day.
Begin strengthening exercises for your muscles as recommended.
Surgery may be necessary in cases when there is no response to other forms of treatment.
To reduce your chances of ITBS, take these steps:
American Academy of Orthopaedic Surgeons
American College of Sports Medicine
Canadian Orthopaedic Association
The University of British Columbia Department of Orthopaedics
Baker RL, Souza RB, et al. Iliotibial band syndrome: soft tissue and biomechanical factors in evaluation and treatment. PMR. 2011;3(6):550-561.
Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35(5):451-459.
Iliotibial band (ITB) syndrome.
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Updated September 5, 2012. Accessed May 3, 2013.
Strauss EJ, et al. Iliotibial band syndrome: evaluation and management. J Am Acad Orthop Surg. 2011 Dec;19(12):728-36.
Last reviewed March 2014 by Teresa Briedwell, PT, DPT, OCS
Last Updated: 4/29/2014