Iliotibial Band Syndrome

by / Monday, 01 April 2019 / Published in Blog, Hip Pain, Knee Pain

The iliotibial band is a strong, thick band of fibrous tissue that runs along the outside of the leg. It starts at the hip and runs along the outer thigh and attaches on the outside edge of the tibia just below the knee joint. It supports and helps provide stability to the outside of the knee joint during movement. The iliotibial band is a condition causing outer knee or hip pain occurring due to inflammation of the iliotibial band, primarily from overuse.  The pain is often more intense when descending stairs or getting up from a seated position. The iliotibial band friction syndrome can cause a nagging, dull ache, or could flare into a sharp, acute pain felt at the outer knee and lower thigh. The IT band syndrome is a common injury in runners or other athletes.


The most common causes of IT band syndrome include overuse, increasing training too quickly, overtraining syndrome, returning from injury too soon, faulty biomechanics, etc. IT band syndrome is common in runners who perform unbalanced, repetitive exercises, especially running along the sloping edges of the road, causing the outside foot to be lower than the inside foot and pelvis to tilt to one side stressing the IT band. Excessive pronation of the foot, leg length discrepancy, lateral pelvic tilt, and “bowed” legs also predispose to the IT band syndrome. Muscle tightness or lack of flexibility in the gluteal or quadriceps muscles may increase the risk of IT band injuries as well.

Overtraining can worsen the IT band syndrome and should be avoided

Treatment of the IT band syndrome includes RICE (rest, ice, compression, elevation). In addition, physical therapy is an important part of management. A physical therapist may use ultrasound the injured tissues heal more quickly and can help with flexibility exercises and fix biomechanical errors. Runners with IT band pain should abstain from over-exerting. Apart from that, a foam-roller myofascial release can be a helpful technique as well. Anti-inflammatory/analgesic agents, such as NSAIDs can be taken over the counter to help reduce pain and inflammation. Overall, patients need rest in order to recover and should be factored into a balanced training program.


If you are an athlete or have a rigorous physical activity pattern, then it is important to take precautions to prevent chronic IT band syndrome. As a runner, you should prevent running overuse injuries by increasing the distance by no more than 10 percent per week, taking a rest day between running days, and building speed or incline intensity gradually. One-leg squat exercises help with the external hip rotators. IT band stretching exercises may help prevent irritation from IT band tightness as well. It is important to wear the right shoes with the proper level of cushioning. Sometimes, it is worthwhile to use orthotics or inserts, particularly if you have high arches. In general, it is advisable to change running shoes at least every 400 miles. As mentioned before, overtraining can worsen the IT band syndrome and should be avoided. There should be a balanced training program, with cross-training and with rest days interspersed. In some cases, backward running can be helpful in correcting muscle imbalance and reduce pressure on the knees. With these tips in mind, one can lead to a full recovery from the IT band syndrome or prevent it in the first place.