IT Band Syndrome

The iliotibial (IT) band is a thick band of fibrous tissue that runs along the outside of the leg, beginning at the hip and extending to the outer side of the shinbone just below the knee joint. The band functions in coordination with several thigh muscles to provide stability to the outside of the knee joint.

Iliotibial band syndrome (ITBS) is caused by inflammation of the IT band and bursa between the lateral femoral condyle and IT band. During flexion and extension of the knee, the IT band rubs over the femoral condyle (thigh bone), which leads to irritation. When the IT band is inflamed, the band does not glide easily, and pain associated with movement is the result. Symptoms of ITBS include pain or aching on the outer side of the knee. This usually happens in the middle or at the end of a run.

Those who suddenly increase their level of activity, such as runners who increase their mileage, often develop ITBS. Others who are prone to ITBS include individuals with mechanical problems in their gait, such those who overpronate, have leg length discrepancies, or are bow-legged.

Diagnosis

The diagnosis of ITBS usually can be made without any complicated tests. A health care professional will take a history and ask about other injuries that may have occurred in the past. X-rays may be taken to make sure that there are no previous injuries that could be adding to the problem. Pain on the outside of the knee can be caused by conditions other than ITBS. A doctor will perform an examination of the knee and will look at the entire leg to rule out other conditions.

Treatment

Treatment for ITBS includes rest, ice, compression, elevation, anti-inflammatory medications such as ibuprofen, temporary reduction of training, stretching the IT band, and strengthening the hip abductors (outside leg muscles and gluteus medius). Surgery is rarely needed to correct IT band problems. Surgery consists of removing the bursa and releasing, or lengthening, the IT band just enough so that the friction is reduced when the knee is bent and straightened.

Prevention

The following steps can be taken to help prevent the onset of ITBS:

  • Proper conditioning
  • Gradual introduction of activity
  • Warm-up and stretching prior to exercise
  • Wearing appropriate shoes for activity
  • Avoiding crowned surfaces or too much running
    around a track
  • Shortening the running stride

Rehabilitation

  • Quad sets: Sit with legs extended and fully contract the muscles of the front thighs. Hold contractions for 10 seconds. Repeat 10 times for three sets.
  • Hip abduction: Lie on side of uninjured leg, so that the injured leg is on top of the uninjured leg. Lift the injured leg at the hip away from the body. Lift the leg as high as possible and hold for five to 10 seconds, then slowly lower the leg. Repeat 10 times for three sets.
  • Half-knee bends: Stand with feet shoulder width apart. Slowly lower the body weight by bending the knees. Do not perform a full squat, but rather stop at about half of the full squat position and then fully extend the knees. If there is pain before achieving the half-squat position, stop downward travel at that point. Repeat 10 times for three sets.
  • Iliotibial band stretch (standing): Cross your uninjured leg in front of your injured leg and bend down and touch your toes.You can move your hands across the floor toward the uninjured side and you will feel more stretch on the outside of your thigh on the injured side. Hold this position for 15 to 30 seconds. Return to the starting position. Repeat three times.
  • Iliotibial band stretch (side-leaning): Stand sideways near a wall, your injured leg toward the inside. Place the hand of your injured side on the wall for support. Cross your uninjured leg over the injured leg, keeping the foot of the injured leg stable. Lean into the wall. Hold the stretch for 15 seconds and repeat three times.
  • Standing calf stretch: Facing a wall, put your hands against the wall at about eye level. Keep the injured leg back, the uninjured leg forward, and the heel of your injured leg on the floor. Turn your injured foot slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a stretch in the back of your calf. Hold for 15 to 30 seconds. Repeat three times.
  • Hamstring sretch on wall: Lie on your back with your buttocks close to a doorway, and extend your legs straight out in front of you along the floor. Raise the injured leg and rest it against the wall next to the doorframe. Your other leg should extend through the doorway. You should feel a stretch in the back of your thigh. Hold this position for 15 to 30 seconds. Repeat three times.
  • Quadriceps stretch: Stand an arm's length away from the wall, facing straight ahead. Brace yourself by keeping the hand on the uninjured side against the wall. With your other hand, grasp the ankle of the injured leg and pull your heel toward your buttocks. Don't arch or twist your back, and keep your knees together. Hold this stretch for 15 to 30 seconds. Repeat three times.
Content on this page is for informational purposes only. If injured, please consult a physician.

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