IT Band Syndrome

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IT band syndrome (or iliotibial band syndrome) occurs when the fascia connecting your pelvis and shinbone becomes irritated due to running, jumping or other activity on your part. Running or jumping causes this fascia (the it band) to move from the back of the thigh bone to the front. It it is tight, this movement causes irritation and inflammation, which lead to  outer knee pain and the appearance of it band syndrome. This pain is the key symptom of it band syndrome. Treatment normally requires rest, i.e. abstaining from strenuous activity, for a period as well as icing the knee.

The it band runs along the outer thigh and, as mentioned above, connects the pelvic area and tibia (shinbone). Its function is to stabilize the outer knee as the knee joint flexes and extends. As the knee flexes and extends, it travels around the thigh and crosses a bony prominence (the lateral epicondyle) on the thigh. There is a  bursa at the lateral epicondyle that normally allows the band to travel smoothly over the bump. However, with repeated movements over the bump, the increase in friction produced when it crosses the bump can result in pain and irritation. The result is iliotibial band syndrome.

IT band syndrome is extremely common among runners and cyclists. According to the Journal of Arthroscopic and Related Surgery, it accounts for up to 12% of all injuries due to running.

Risk Factors

You are at increased risk of developing iliotibial band syndrome if you:

  • Either run or cycle extensively;
  • Extensively performing activities that require deep and repetitive knee bends (e.g. going up or down stairs);
  • Have an unusually tight iliotibial band (for genetic reasons that are unclear);
  • Are bowlegged;
  • Have legs of unequal length;
  • Suffer from knee arthritis or flat feet; or
  • Have unusually weak hip, abdominal or gluteal muscles.


As previously mentioned, the main symptom of it band syndrome is pain and irritation of the outer knee, where the band passes over the lateral epicondyle of the thigh. This symptom is commonly experienced with other knee injuries like ligament or meniscus tears. However, a critical difference is that the other injuries also produce swelling at the knee. With iliotibial band syndrome, you will experience just outer knee pain and no swelling.

Another symptom that appears after a long period with this injury is a thickening of the it band. Doctors can observe this change using an MRI.

Treatment Of IT Band Syndrome

This injury is normally treated conservatively. Your doctor will suggest a period of rest or reduced athletic activity (running, cycling, etc.). Once the pain of the injury has gone away, you can resume your activities – gradually.

Other conservative treatments for it band syndrome are:

  • Wearing a knee band or strap above the knee to control movement of the it band;
  • Icing your outer knee every 15-30 minutes (or applying a cold compress) for additional pain control;
  • If your pain is severe, you can also take a non prescription pain medication like aspirin.
  • Applying compression to your knee using an elastic bandage or a knee sleeve;
  • Elevating your knee above heart level when you are sitting or lying down.

If conservative treatments are not successful, doctors may suggest a surgical approach. These surgeries will usually be arthroscopic in nature. The surgeon will make a small incision in the knee and perform the operation under the guidance of a very small camera inserted through the incision.

One surgical procedure is to cut away the inflammation surrounding the it band. A second option may be to cut off a small triangular part and re-attach that part to the end to increase its length. This will reduce its tightness and with that the friction as it crosses the lateral epicondyle of the femur.

Prevention Of IT Band Syndrome

You may be wondering at this point whether there is anything you can do to reduce the risk that the injury recurs. There is – a physiotherapist can prescribe a series of stretching exercises to improve it band flexibility. Foam rollers are very useful in helping to achieve this additional muscle flexibility.

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