Iliotibial Band Syndrome
(IT Band Friction Syndrome; ITBFS; ITBS)
|Tendons of the Lateral Knee|
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- Structural abnormalities, such as a short, tight IT band
- Problems related to the foot, ankle, or hip
- Opposing muscle imbalances, such as the quadriceps stronger than hamstrings
- A prominent lateral femoral epicondyle, the bony structure on the outer side of the knee
- Inward rotation of the leg
- Angle where knee flexes
- Legs of different lengths
- Certain sports with repetitive motions, such as running and cycling
- Incorrect training technique
- Increasing cycling or running mileage too quickly
- Running up and down hills
- Using damaged or worn out equipment or footwear
- Wearing improper shoes for a sport or athletic activity
- Athletic equipment that is not properly fit to the user, such as a bicycle
- Dull aching or burning sensation on the outside of the knee during or after activity
- Sharp stabbing pain on the outside of the knee during or after activity
- Pain that shows up in the hip, known as referred pain
- Progressive, worsening pain
- Snapping, creaking, or popping when the knee is bent and then straightened
- Obers test—determines the tightness of the ITB
- Rennes test—specifies the area of pain while full weight is placed on the bent leg
- Nobles test—determines the area of pain while the leg is flexed at a certain angle
- Rest—Activities may need to be restricted. Normal activities will be gradually reintroduced as the injury heals.
- Ice—Ice therapy may help relieve swelling. Heat therapy may be advised when normal activities are reintroduced.
- An orthotic device may be advised to help control rotation of the foot and stabilize the knee.
- Learning proper training techniques
- Increasing mileage run gradually
- Wearing appropriate shoes for each sport
- Replacing athletic shoes as they show signs of wear
- Being aware of running surfaces
- Using properly fitted equipment
- Strengthening quadriceps, hamstrings, and gluteal muscles
American College of Sports Medicine http://acsm.org
OrthoInfo—American Academy of Orthopaedic Surgeons http://orthoinfo.org
Canadian Orthopaedic Association http://www.coa-aco.org
Department of Orthopaedics—The University of British Columbia http://www.orthosurgery.ubc.ca
Baker RL, Souza RB, et al. Iliotibial band syndrome: soft tissue and biomechanical factors in evaluation and treatment. PMR. 2011;3(6):550-561.
Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35(5):451-459.
Iliotibial band (ITB) syndrome. http://www.ebscohost.com/dynamed. Updated July 10, 2013. Accessed March 4, 2015.
Strauss EJ, et al. Iliotibial band syndrome: evaluation and management. J Am Acad Orthop Surg. 2011 Dec;19(12):728-36.
- Reviewer: Teresa Briedwell, PT, DPT, OCS
- Review Date: 03/2015 -
- Update Date: 03/04/2015 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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