IT Band Syndrome

Are you experiencing a sharp pain in your outer knee or hip? You may have iliotibial band (IT band) syndrome. Let’s delve into what this injury is and how you can treat it.

What is it?

The iliotibial band, commonly known as the IT band, is a tendon that runs along the outer leg from the top of the pelvic bone to the knee. IT band syndrome occurs when this tendon becomes irritated or swollen from rubbing against the hip or knee bones.

Causes:

The IT band rubs against the bone when it gets too tense or tight. Physical activity itself is mostly what irritates your IT band. A motion such as running, for example, involves repeatedly extending and bending in your knee, stretching out your IT band and causing it to tighten or become swollen. Athletes who frequently utilize their knees and hips, such as runners and cyclists, are more likely to have a tight IT band.

Some other causes of a tight IT band include:

• Excessive foot pronation: this is when your foot naturally rotates outward, stretching out the IT band

• Hip abductor weakness: your hip abductor turns your hip away from your body, a weakened ability to rotate your hip might cause IT band tension

• Internal tibial torsion: this is when your tibia (shinbone) is twisted inward toward your body, pulling the IT band closer to the bone

• Preexisting iliotibial band tightness: you might have been born with a tighter IT band

Some reasons why your tight IT band might rub against your bone include:

• Before exercise:

  • Not stretching enough

  • Warming up too quickly

• During exercise:

  • Pushing too hard

  • Using worn-out shoes

  • Running on a tilted or curved surface

  • Running downhill

• After exercise:

  • Cooling down too quickly

  • Not getting enough rest

IT band syndrome can be caused by a combination of many of these factors.

Symptoms:

Here are some symptoms of IT band syndrome:

• Hip pain

• Knee pain

• Clicking, snapping, popping sensations

• Grating feeling with knee or hip movement (crepitus)

• Warmth/redness in the knee or hip area

If you develop IT band syndrome, you can expect the initial pain to be aching and burning. As you exercise your leg, the syndrome might worsen and you might feel a sharp pain. However, the condition can differ from person to person. Make sure to describe to your doctor or physical therapist the location of the pain and how it feels.

Diagnosis:

Your healthcare provider might diagnose you with IT band syndrome after discussing your symptoms or by doing a physical examination. Special tests for IT band syndrome called Noble and Ober tests may be performed. There are several steps, including feeling the outside of the knee, moving the hip away from the body, and moving the knee at different angles to see if it causes pain.

An MRI might be ordered if your healthcare provider is unsure about your diagnosis. The MRI would help to exclude other injuries like meniscal tears or lateral collateral ligament (LCL) injuries. An ultrasound can show how your IT band moves as you extend and flex your knee or hip.

Treatment:

Here are some treatments for IT band syndrome:

• Rest: stop or reduce exercising the injured leg to allow it to heal

• Physical therapy: your physical therapist can teach you stretches and strengthening exercises

• Manual therapy: foam roller and massaging

• Posture training: the way you hold your body can impact your IT band syndrome

• Medication: some nonsteroidal anti-inflammatory drugs (NSAIDS) include Ibuprofen (Advil®, Motrin®) and Naproxen (Aleve®), talk to your healthcare provider for proper dosage

• Surgery: rare, but may be used if physical therapy and medication don’t work

Prevention:

Here are some ways you can prevent IT band syndrome:

• Avoid running up or down hills/slanted surfaces

• Pay attention to technique in your exercises

• Shift training intensity gradually (Ex: slowly speed up/slow down when you’re bicycling instead of suddenly switching speeds)

• Slowly warm up and cool down

• Wear supportive shoes

Sources:

“Iliotibial Band Syndrome (ITBS): Causes, Symptoms & Treatment.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/21967-iliotibial-band-syndrome. Accessed 25 Dec. 2023.

“Iliotibial Band Syndrome - Aftercare: Medlineplus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, medlineplus.gov/ency/patientinstructions/000683.htm. Accessed 25 Dec. 2023.

“It Band Syndrome (Hip Bursitis) Symptoms and Treatments.” UPMC, www.upmc.com/services/sports-medicine/conditions/it-band-syndrome. Accessed 25 Dec. 2023.