IT Band Syndrome

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IT Band Syndrome (or iliotibial band syndrome) is a common type of knee injury caused by damage to the iliotibial band, a thick band of tissue that connects the pelvis to the knee.  This type of injury occurs when the band, which moves from the back of the femur (thighbone)  to the front during the act of running, becomes inflamed by friction against the knee. Symptoms of iliotibial band syndrome include a stinging sensation on the outer part of the thigh and just above the knee.  Doctors usually take a conservative approach to treatment of IT band syndrome. They usually opt for advising a break from strenuous activity for a period while icing the painful area to control pain and inflammation.

This is one of the most widespread injuries among runners. It is especially prevalent among those experiencing pain on the outside of the knee. According to, it is responsible for some 22% of all lower extremity injuries in runners. The Journal of Arthroscopic and Related Surgery has also reported that this injury comprises 12% of all running related injuries and that up to 12% of runners have experienced it.

The IT Band

The iliotibial band is a long piece of connective tissue that runs along the outside of the upper leg and connects the hip to the knee and shinbone. This band plays a key role in hip extension, abduction and rotation. It is also involved in stabilizing and moving the side of the knee while keeping the outer thigh protected.

Iliotibial band syndrome is an overuse injury that is caused when the band is excessively tight against the thigh bone and repetitively rubs against it when the patient moves his or her knee. The friction from this rubbing causes pain and irritation. The excessive tightness of the band, and the resultant friction and pain, only occurs in some individuals for reasons that researchers do not clearly understand.

Risk Factors For IT Band Syndrome

The knee movements that causes iliotibial band syndrome are especially common among runners and cyclists. For this reason, extensive performing of these  activities is one of the primary risk factors that increase exposure to it band syndrome. Other factors that increase this risk are climbing and descending stairs or remaining seated for long periods with the knees bent.

Other risk factors are:

  • Being born with a tight iliotibial band (reasons for this are unclear);
  • Having knee arthritis or flat feet;
  • Being bowlegged;
  • Having weak hip, gluteal or abdominal muscles;or
  • Having legs of unequal length.

Symptoms & Treatment Of IT Band Syndrome


As mentioned above, the symptoms of this condition include pain and irritation on the outer thigh, just above the knee. This is similar to the symptoms that are linked to other knee injuries like a ligament or meniscus tear. However, unlike those injuries, iliotibial band syndrome does not usually produce swelling. The pain usually starts a few minutes after commencing the athletic activity that causes it (running, cycling, etc.).

Over time, the iliotibial band will start to thicken, a development that doctors can observe via an MRI.


Doctors usually opt for conservative treatment of IT Band Syndrome, including:

  • Rest – refraining from running, cycling or other athletic activity for a while until the pain and irritation have subsided;
  • Wearing a knee strap just above the knee to restrict movement of the iliotibial band and reduce the resulting irritation. This differs from how such a strap is worn for patellar tendinitis, for example. For other knee conditions, the patient wears the knee strap just below the knee;
  • Icing the outer knee for further pain control;
  • Using non steroidal anti inflammatory pain medication if the pain is exceptionally severe.

If the patient intends to continue athletic pursuits on a long term basis, doctors may suggest initiating an exercise program that reduces the risk of recurrence of the condition. These exercises may include heel drops, hip hikes, side planks, side leg abduction and clamshell.

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