Iliotibial Band Syndrome

A Common Cause of Knee Pain

Jul 18, 2009 Steven M. Cohen

Iliotibial band syndrome is a common cause of pain along the outer knee, primarily in endurance athletes.

Iliotibial band syndrome is a common cause of knee pain in endurance athletes. Iliotibial band (ITB) syndrome generally causes pain along the outer portion of the knee, and is considered an overuse injury. The condition was first recognized and described in the 1970s, and is most commonly seen in runners, although cyclists and dancer may also suffer from the condition. As with most overuse injuries, the R.I.C.E. Protocol is useful, particularly in the early stages. For chronic injury, additional rest and therapy are suggested, under physician supervision.

What is the Iliotibial Band?

The ITB is a structure comprised of both connective tissue and muscle. It runs from the iliac bone (the “wing” of the pelvis) to the upper portion of the tibia (shin bone). The ends of the ITB are made of tough, fibrous connective tissue. The middle portion of the ITB is muscle – the tensor fascia lata. The ITB functions to stabilize the hip and knee during running, by preventing excess adduction (or inward movement) of the thigh. Although the ITB runs along the length of the outside of the thigh, the pain from ITB syndrome is generally along the outside of the knee.

Risk Factors for Iliotibial Band Syndrome

ITB syndrome is an overuse injury, with the following known risk factors:

  • Individuals who are new to running/cycling/dancing.
  • Athletes who are increasing weekly mileage.
  • Athletes running on “crowned” roads.
  • Athletes training on a running track.
  • Individuals with a leg length discrepancy.

Diagnosis of Iliotibial Band Syndrome

  • Physical examination – The physician will palpate (or press) the outside of the knee, in the area of the lateral femoral condyle. This is the bony knob-like structure on the outside of the joint, at the approximate level of the kneecap. ITB sufferers will experience pain at the palpation point, especially when flexing or extending the knee.
  • Imaging studies – X-rays may be taken to rule out other conditions, such as fracture or arthritis. MRI may be performed in some cases, to look for strain of the ITB.

Treatment of Iliotibial Band Syndrome

  • Conservative treatment is generally used in cases of ITB syndrome. In the initial phase, R.I.C.E protocol (rest, ice, compression and elevation) may be helpful. In the more chronic phase, external heat may be applied, along with gentle stretching.
  • Targeted stretching is often prescribed, to lengthen the ITB. This will reduce tension on the ITB during exercise, decreasing the risk for a recurrence when training is resumed.
  • Massage therapy may also be utilized to mobilize the ITB, and decrease soreness.
  • In severe cases, ITB release surgery has be used to relieve pain.

The copyright of the article Iliotibial Band Syndrome in Sports Medicine is owned by Steven M. Cohen. Permission to republish Iliotibial Band Syndrome in print or online must be granted by the author in writing.
Iliotibial Band Syndrom in Cyclists, wikimedia commons Iliotibial Band Syndrom in Cyclists