What is Iliotibial Band Syndrome?

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  • Written By: Karyn Maier
  • Edited By: Bronwyn Harris
  • Last Modified Date: 09 November 2018
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Iliotibial band syndrome (ITBS) refers to connective tissue damage to one or both knees. Specifically, the damage involves the iliotibial band, which runs from the outside of the hip, down the thigh, and extends over the knee to connect to the shin bone. The function of this band is to keep the knee stable while in motion. However, repetitive stress can generate friction between the band and the outside of the knee, particularly whenever the latter is forced to bear weight while bent. As you might suspect, iliotibial band syndrome is a common type of running injury.

The condition is characterized by inflammation and pain concentrated on the outside of the knee, although this may extend to the area just below the knee as well. Tenderness to the region may also be experienced, which may indicate that the iliotibial band may have become too taut. However, pain or discomfort may not be apparent while engaged in an activity involving flexing of the knee. Initially, it may only occur as the foot or feet come into contact with the ground while walking or running. As iliotibial band syndrome progresses, however, pain may become increasingly persistent, even when at rest.


Running is not the only cause of iliotibial band syndrome. In fact, it is often seen in people who regularly bicycle, practice martial arts, or play sports on a court (i.e., tennis). Even frequent bowling can lead to developing iliotibial band syndrome, as can climbing a lot of stairs. In addition, some women experience symptoms for the first time during pregnancy.

Structural abnormalities can also promote iliotibial band syndrome. For instance, people who have a difference in the length of the legs are more prone to this condition, as well as those who are bow-legged or who have poor arches in the feet. Of course, the risk of developing this syndrome decreases when these types of conditions are corrected.

The most common causes of iliotibial band syndrome, however, are the most easily prevented. In fact, inadequate footwear and workout habits are common culprits. For example, consistently running on a sloped surface places undue stress on the knees, which are forced to remain at an angle of 30 or more degrees. This includes “running” on a sloped treadmill, as well as on natural terrain. In addition, simply replacing footwear at the first sign of wear on the outer heel can help to prevent iliotibial band syndrome from occurring.

Fortunately, most cases of iliotibial band syndrome are temporary and easy to treat. The first course of action is to cease the activity that caused it, in order to allow the band to heal. Secondly, the outside of the affected knee should be iced for 20-minute intervals every four hours. In addition, an anti-inflammatory medication, such as aspirin, can help to relieve pain and inflammation. If pain is severe, however, your physician may suggest an injection of cortisone.



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