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IT Band Syndrome

If you're a runner, you may deal with a painful knee problem called IT band syndrome.

IT stands for iliotibial, meaning the band of tissue that runs from hip to knee on the outside of your leg. When it's inflamed, it can cause a terrible ache on the outside of your knee.

Other athletes, like skiers and basketball players, also deal with IT band syndrome. It's more common among women than men.

IT band syndrome is treatable. For many people, stretching and other interventions can help.

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What Is IT Band Syndrome?

The IT (iliotibial) band is a thick band of fibrous tissue that runs along the outside of your leg. It starts at the hip and extends to the outer side of the shinbone just below the knee joint.

The IT band works with the muscles in your thigh to provide support to the outside of the knee joint.

Doctors diagnose IT band syndrome when the IT band becomes too tight. This causes friction at the top of your hip or near your knee and results in swelling and pain.

IT band syndrome relates to hip bursitis (also called greater trochanteric bursitis) because a tight IT band can inflame the bursa. The bursa is the fluid-filled sac around the hip.

IT band syndrome is one of the most common running injuries, affecting as many as 14% of runners. Most people have it on one side, but it can occur on both sides.

What causes IT band syndrome?

When you bend and straighten your knee, the IT band rubs over the thighbone. Doing this over and over can cause inflammation.

When the IT band becomes inflamed, it doesn't glide easily. This may prove painful.

Research has found that compression also can cause IT band syndrome. In other words, the IT band pushes on the tissue around it.

It's mostly activity itself that causes IT band irritation.

For instance, a motion like running causes repeated extending and bending in your knee. This motion stretches the band, which makes it become tight, and even swollen.

Though you can get IT band syndrome at any time, you're more likely to get it when starting a new exercise program.

What are the risk factors and complications of IT band syndrome?

IT band syndrome risks

People at risk of IT band syndrome are those who suddenly increase their level of activity. This can include runners who increase their mileage.

Mechanical problems in your gait are also a main cause of IT band syndrome.

These include having:

  • Flat feet.
  • Uneven leg length.
  • Bow legs.

IT band syndrome complications

IT band syndrome can cause pain or aching on the outer side of the knee.

Symptoms of IT band syndrome can occur in the middle or at the end of a run. The pain can become nearly unbearable during activity.

The earlier you seek treatment, the sooner you can get back to your normal routine.

How can you prevent IT band syndrome?

You may prevent IT band syndrome (or stop it from getting worse) with exercises and stretches.

Some tips to keep in mind:

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

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What Are the Symptoms of IT Band Syndrome?

IT band syndrome often causes symptoms such as:

  • Pain or aching on the outer side of the knee.
  • A clicking or rubbing feeling on the side of your knee.
  • Pain that increases with activity (and often only hurts with activity).
  • Pain that spreads up the thigh into the hip.

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How do you Diagnose IT Band Syndrome?

In most cases, doctors can diagnose IT band syndrome without any complex tests.

Because a number of conditions can cause pain on the outside of the knee, your doctor will:

  • Perform a physical exam and look at your entire leg. This includes moving your leg into different positions.
  • Ask you to do a series of activities that test your range of motion.
  • Ask about your exercise habits including what may have changed lately. For instance, did you start training for a marathon and increase mileage?
  • Ask about any other past injuries.

Often, you won't need any imaging tests to confirm the diagnosis. But your doctor may order x-rays to make sure prior injuries aren't adding to the problem.

If they suspect a different issue, like a muscle tear or ligament injury, they may order an MRI. This is a test that can see the soft tissue.

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How Do You Treat IT Band Syndrome?

At UPMC Sports Medicine, doctors will create a treatment plan for IT band syndrome aimed to:

  • Strengthen your outside leg muscles and hip abductors.
  • Relieve inflammation.
  • Ease hip pain.

Nonsurgical IT band syndrome treatment

IT band syndrome treatments can include:

  • Rest, ice, compression, and elevation (RICE).
  • Anti-inflammatory drugs such as ibuprofen.
  • Cortisone shots.
  • Temporary reduction of training.
  • Orthotics to correct alignment.
  • Stretching the IT band.

IT band syndrome surgery

People with IT band syndrome rarely need surgery to correct their hip problems.

Surgery involves removing the bursa and loosening the IT band just enough to reduce friction when bending and straightening your knee.

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