Iliotibial band syndrome, or ITBS (not to be confused with another distantly related IBS acronym) describes an irritation of the tissues near the distal attachment of the iliotibial band.
Where is the IT Band?
The iliotibial band runs along the outside of your thigh, from pelvis to tibia (shin bone). It crosses both your hip and knee joint. The ITB is divided anatomically into two distinct portions- a proximal (near the center of the body/closer to the pelvis) “tendinous” segment and a distal (closer to the knee) “ligamentous” component. (2) The ITB is very important as it stabilizes the lateral part of the knee as the joint flexes and extends. If you were to feel down your thigh on the outside and run into the bony part on the outside of your knee, you'd be in the right area.
What is ITBS? How do I know if I have it?
ITB syndrome is more common in groups of people that participate in activities that involve repeated flexion and extension of the knee while in a single leg stance and is most common in runners and cyclists (1). This also includes soccer, basketball, etc. ITB syndrome is also more likely to develop when running in worn-out shoes, running on uneven terrain, or running in cold weather. Maybe just avoid running at all- haha just kidding. . . mostly.
Patients with ITB syndrome will often complain or a sharp or burning pain right around their knee. (3) It’s possible that pain may radiate slightly proximally toward the hip or distally toward the knee joint. (3)
Can you help me?!?!
ITB syndrome can be conservatively managed (PHEW), with reports of 44% patients having complete resolution at two months and 92% at six months. (4)
Where the magic happens....
Conservative management includes:
· Activity modification (don't worry- not always necessary)
· Stretching <--- We can help with this
·Torture tools will likely be used (gently...ok, well, it will be manageable) to get a sense on where irritation sites and adhesion's are located. <---We can help with this
·The use of foam rollers or massage may help to promote muscle flexibility and decrease stiffness throughout the iliotibial band (5) <---We can help with this
· Hip abductor strengthening!!! <--- We can help with this
**NOTE: one of the most important aspects of treatment includes strengthening the hip abductors and external rotators- patients who incorporate hip abductor strengthening into their ITB rehab experienced symptom resolution within six weeks (6)
If you or someone you know are struggling with knee pain, do us a solid and give them our number! Until next time friends, Dr. Amy
1. Messier SP, Edwards DG, Martin DF, Lowery RB, Cannon DW, James MK, Curl WW, Read HM, Hunter DM. Etiology of iliotibial band friction syndrome in distance runners. Medicine and science in sports and exercise. 1995 Jan 1;27(7):951-60.
2. Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin M. The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. Journal of anatomy. 2006 Mar;208(3):309-16
3. Fredericson M, Weir A. Practical management of iliotibial band friction syndrome in runners. Clinical Journal of Sport Medicine. 2006 May 1;16(3):261-8.
4. Beals C, Flanigan D. A review of treatments for iliotibial band syndrome in the athletic population. Journal of Sports Medicine. 2013 Oct 2;2013.
5. Michaud T. The Real Cause of Iliotibial Band Syndrome. Dynamic Chiropractic. 2012;30:24.
6. Fredericson M, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA. Hip abductor weakness in distance runners with iliotibial band syndrome. Clinical Journal of Sport Medicine. 2000 Jul 1;10(3):169-75.