Iliotibial Band Syndrome (ITBS)

Iliotibial Band Syndrome (ITBS)

Iliotibial band syndrome (ITBS) is an overuse injury of the connective tissue on the outer part of the thigh and knee. It often causes pain and tenderness in the area just above the knee joint. It is the most common cause of lateral knee pain, particularly for runners and bicyclists.


The iliotibial band is a long, thick band of tissue. It begins at the iliac crest in the pelvis, runs down the lateral part of the thigh, and crosses the knee to attach into the top part of the tibia. The IT band helps stabilize the outer part of the knee through its entire range of motion. It also helps move the hip away from the midline and assists in knee flexion and extension.

ITBS Causes

ITBS is an overuse injury that most often affects long-distance runners, bicyclists, and athletes who repeatedly squat. This syndrome may develop as the result of a combination of different issues. Poor training habits are a common cause of ITBS. For example, not warming up or cooling down properly, wearing worn out sneakers, and not resting enough between workouts. Pushing yourself too hard can also cause ITBS. 

Runners might also experience ITBS due to training on the wrong surfaces. Running downhill is especially stressful on the IT band because it has to work so hard to stabilize the knee. Repeatedly running on only one side of the road can also cause inflammation. This is because most roads slope toward the curb, causing your outside foot to be lower and tilting your hips. Training on banked surfaces can also cause inflammation. You should try to train on flat surfaces.

There are also some physical conditions that can increase your chances of getting IT band syndrome. Some of these include bowed legs, knee arthritis, having one leg that is longer than the other, or weakness in your abs, glutes, or hip muscles. People who rotate their foot or ankle inward when they walk or run may also have a higher chance of developing ITBS.

ITBS Symptoms

The main symptom of ITBS is pain on the outer side of your knee, just above the knee joint. In the early stages of this condition, the pain might go away when you warm up. However, over time you may notice that the pain actually gets worse as you exercise. You may also experience other symptoms like an aching, burning, or tender sensation on the outside of the knee. You could also feel a click, pop, or snapping on the outside of the knee. Pain might radiate up and down you leg and you may also feel warmth or redness on the outside of the knee. If these symptoms are ignored, the inflammation can continue and develop scars in the bursa. Eventually this can lead to a decrease in the knee’s range of motion.

ITBS Treatment

Treatment for iliotibial band syndrome begins with home methods like rest, ice, compression, and elevation (RICE). Anti-inflammatory medications like ibuprofen could also be helpful in controlling the pain and inflammation caused by the syndrome. Stretching, massaging, and using foam rollers at the site of the pain and inflammation could also be used.

When these initial home methods do not adequately relieve a patient’s symptoms, physical therapy might be necessary. These treatments will likely focus on flexibility and stretching. Corticosteroid injections could also be beneficial. 

For most patients, the above nonsurgical treatments will suffice in treating ITBS. However, surgery is an option for patients who do not experience relief. Arthroscopy could be used to find the inflammation around the IT band and cut it away.  

Iliotibial Band Syndrome at OAR 

If you are experiencing any of the symptoms of ITBS, it is important to get diagnosed properly. Being diagnosed is essential so you know what kinds of activities you should avoid to prevent further injury and scarring. The expert team at Orthopaedic Associates of Riverside are ready to diagnose your knee pain and help you find the treatment plan that is right for you.

Contact us today!