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Iliotibial band syndrome

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Title: Iliotibial band syndrome  
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Iliotibial band syndrome

Iliotibial band syndrome (ITBS or ITBFS, for iliotibial band friction syndrome[1]) is a common injury to the knee, generally associated with running, cycling, hiking or weight-lifting (especially squats).


Iliotibial band syndrome is one of the leading causes of lateral knee pain in runners. The iliotibial band is a thick band of fascia on the lateral aspect of the knee, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running, as it moves from behind the femur to the front of the femur during activity. The continual rubbing of the band over the lateral femoral epicondyle, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed.


ITBS symptoms range from a stinging sensation just above the knee joint, to swelling or thickening of the tissue in the area where the band moves over the femur. The stinging sensation just above the knee joint is felt on the outside of the knee or along the entire length of the iliotibial band. Pain may not occur immediately during activity, but may intensify over time. Pain is most commonly felt when the foot strikes the ground, and pain might persist after activity. Pain may also be present above and below the knee, where the ITB attaches to the tibia. It will also hurt if you twist your knee to turn a corner.


ITBS can result from one or more of the following: training habits, anatomical abnormalities, or muscular imbalances:

Training habits

  • Consistently running on a horizontally banked surface (such as the shoulder of a road or an indoor track) on which the downhill leg is bent slightly inward, causing extreme stretching of the band against the femur
  • Inadequate warm-up or cool-down
  • Excessive up-hill and down-hill running
  • Positioning the feet "toed-in" to an excessive angle when cycling
  • Running up and down stairs
  • Hiking long distances
  • Rowing
  • Breaststroke
  • Treading water
  • Water polo
  • Resting knee sideways against car door when driving

Abnormalities in leg/feet anatomy

  • High or low arches
  • Supination of the foot
  • Excessive lower-leg rotation due to over-pronation
  • Excessive foot-strike force
  • Uneven leg lengths
  • Bowlegs or tightness about the iliotibial band.

Muscle imbalance

  • Weak hip abductor muscles
  • Weak/non-firing multifidus muscle
  • Uneven left-right stretching of the band, which could be caused by habits such as sitting cross-legged


While ITBS pain can be acute, the iliotibial band can be rested, iced, compressed and elevated (RICE) to reduce pain and inflammation, followed by stretching.[2]

See also


  • Van der Worp et al., Iliotibial Band Syndrome in Runners. A Systematic Review: Sports Med 2012;42(11):969-992
  1. ^ Ellis R, Hing W, Reid D (August 2007). "Iliotibial band friction syndrome—A systematic review". Man Ther 12 (3): 200–8.  
  2. ^ Barber, F. Alan; Sutker, Allan N. "Iliotibial Band Syndrome". Sports Medicine 14 (2): 144–148.  

External links

  • IT Band Syndrome (
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