Iliotibial Band Syndrome

What is Iliotibial Band Syndrome?

Iliotibial (IT) band syndrome is an overuse injury that causes pain on the outside of the knee. It occurs when the iliotibial band, the ligament that runs down the outside of the thigh from the hip to the shin, is tight or inflamed. The IT band attaches to the knee and helps stabilize and move the joint. When the IT band isn't working properly, movement of the knee (and, therefore, running) becomes painful. IT band pain can be severe enough to completely sideline a runner for weeks, or even longer. IT band syndrome is the most common cause of lateral (outside) knee pain in runners and cyclists.

Symptoms

Diagnosis

Diagnosis involves: • Medical history focusing on training patterns and activities • Physical examination to check for tenderness along IT band • Ober's test to assess IT band tightness • Noble compression test to reproduce symptoms • Assessment of running gait and biomechanics • X-rays to rule out other causes of knee pain • MRI if diagnosis is uncertain or symptoms persist • Evaluation of muscle strength and flexibility

Treatment

Treatment typically includes: • Rest and reduction of training mileage • Ice application to reduce inflammation • NSAIDs for pain and inflammation • Physical therapy with stretching and strengthening exercises • Foam rolling and massage of IT band and surrounding muscles • Correction of training errors (reducing mileage, avoiding hills) • Gait analysis and running form correction • Orthotics or shoe modifications if biomechanical issues present • Corticosteroid injections in persistent cases • Surgery (IT band release) rarely needed for chronic cases • Cross-training with non-impact activities during recovery