Iliotibial Band Syndrome

(IT Band Friction Syndrome; ITBFS; ITBS)


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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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


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


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:


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.


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


American College of Sports Medicine
OrthoInfo—American Academy of Orthopaedic Surgeons


Canadian Orthopaedic Association
Department of Orthopaedics—The University of British Columbia


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. . Updated March 24, 2016. Accessed March 26, 2020.
Iliotibial band syndrome. . Accessed March 26, 2020.
Last reviewed February 2020 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS

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