Iliotibial Band Syndrome
(IT Band Syndrome)

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Iliotibial band (IT band) syndrome facts

  • Iliotibial band syndrome is an overuse injury of the connective issues that are located on the outer thigh and knee.
  • The iliotibial band runs along the lateral or outside aspect of the thigh, from the pelvis to the tibia, crossing both the hip and knee joints. The iliotibial band is an important stabilizer structure of the lateral part of the knee as the joint flexes and extends.
  • Inflammation of the iliotibial band can occur as it travels back and forth, crossing the bony prominence of the femoral epicondyle as the knee flexes and extends.
  • Iliotibial band syndrome is an overuse injury causing pain on the outside part of the knee especially during running when the heel strikes the ground.
  • Rest, ice, compression, and elevation (RICE) and anti-inflammatory medications are first-line treatments.
  • Physical therapy may be helpful. Surgery is rarely an option and is sometimes suggested for patients who develop chronic inflammation and who fail to respond to other treatment options.
  • Prevention that includes maintaining flexibility and strength of the low back, hips, knees, and leg muscles is key to avoiding recurrence.

What is iliotibial band (IT band) syndrome?

Iliotibial band syndrome (ITBS or IT band syndrome) is an overuse injury of the connective tissues that are located on the lateral or outer part of thigh and knee. It causes pain and tenderness in those areas, especially just above the knee joint. Iliotibial band syndrome is the most common cause of lateral knee pain in runners and bicyclists.

The iliotibial band is a thick band that 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 or shinbone. The iliotibial (IT) band helps stabilize the outside part of the knee through its range of motion.

Picture of the iliotibial band
Picture of the iliotibial (IT) band

When the knee is flexed, the IT band is located behind the femoral epicondyle, a bony outcropping of the femur or thighbone at the knee joint. The IT band moves forward across the condyle when the knee is extended. There is a sac or bursa that allows the band to glide smoothly across the condyle, but should inflammation occur in this area, the increased friction from repeatedly rubbing the iliotibial band across the bony condyle can cause pain, especially along the outer (lateral) aspect of the knee joint.

If the symptoms are ignored, the inflammation can continue and scarring develop in the bursa, decreasing knee range of motion and causing increasing pain with decreasing activity.

Medically Reviewed by a Doctor on 1/25/2016

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IT Band Symptoms

Knee Pain

Knee pain can be a result of injury or disease of the knee joint. Injury can affect any of the ligaments, bursae, or tendons surrounding the knee joint. Injury can also affect the ligaments, cartilage, menisci (plural for meniscus), and bones within the joint.

Pain can also occur in the knee from diseases or conditions that involve the knee joint, the soft tissues and bones surrounding the knee, or the nerves that supply sensation to the knee area. Overuse injury to the knee can lead to inflammation of the tendon below the kneecap (runner's knee or jumper's knee with infrapatellar tendinitis) and bursitis.