Iliotibial Band Syndrome (IT Band Syndrome)

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What are iliotibial band (IT band) syndrome symptoms and signs?

Pain on the lateral side of the knee is the most common symptom of iliotibial band syndrome and is due to inflammation of the area where the band crosses back and forth at the femoral epicondyle. Initially, there may be a sensation of stinging or needle-like pricks that are often ignored. This can gradually progress to pain every time the heel strikes the ground and finally can become disabling with pain when walking or when climbing up or down steps.

Some patients may feel a snapping or popping sound at the knee, and there may be some swelling either where the band crosses the femoral epicondyle or below the knee where it attaches to the tibia. Occasionally, the pain may radiate along the course of the IT band all the way up to the outer side of the thigh to the hip.

How do health-care professionals diagnose iliotibial band (IT band) syndrome?

Often, the diagnosis of iliotibial band syndrome can be made by the patient's story of symptoms. The patient describes the progression of lateral knee pain that is made worse when the heel strikes the ground. Physical examination is helpful because the area of pain can often be palpated with tenderness and swelling felt over the femoral epicondyle, where the bursa or sac is located.

The health-care professional may also look for leg-length discrepancy, muscle imbalance, and tightness in the legs and back. There is tenderness of the outer thigh just above the knee joint, while the knee and hip joints themselves are normal to examination.

Usually, a full physical examination of the low back and legs, including the hips, knees, and ankles, is performed to detect other potential causes of lateral knee pain.

Plain X-rays are not usually required to help with the diagnosis, but MRI may be used to look for inflammation surrounding and beneath the iliotibial band. The MRI can also exclude other causes of outer knee pain. These include torn cartilage (lateral meniscus tear), sprained lateral collateral ligament, muscle tendon inflammation, and problems between the kneecap and the femur (patellofemoral pain). Most often, X-rays and MRI images are not needed.

Medically Reviewed by a Doctor on 7/13/2017

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