Iliotibial Band Syndrome

By Brian M. Torpey, MD, FACS


Iliotibial band syndrome (IT band syndrome) is a very painful knee soft tissue inflammation that can be quite debilitating and frustrating for recreational weekend warrior athletes as well as for highly competitive elite-caliber athletes. This syndrome occurs as the result of inflammation of the iliotibial band which is a long tendon that runs from the outer aspect of the hip all the way to the knee.

The normal motion of tendon allows it to glide over the side of the outer aspect of the knee joint during normal motion such as walking, running, and biking. If the muscle or tendon associated with the iliotibial band becomes tight, then that rubbing phenomenon can create a friction which irritates the underlying soft tissue or bursa that cushions the tendon.

The friction that occurs from this rubbing phenomenon produces an aching pain that may shoot up the side of the thigh and down the side of the leg. Oftentimes, patients report a snapping or popping sensation on the outside of the knee.

Common causes for the onset of IT band syndrome include overuse of the tendon such as in an individual who initiates an aggressive running or jogging program. Repeated strain to the tendon and bursa in a person who does not have the opportunity to stretch, can cause the outer aspect of the knee to become inflamed.

Fortunately, IT band syndrome responds very well to conservative treatment which includes ice, rest, and often times physical therapy to stretch the muscles and tendons of the thigh and knee. The use of anti-inflammatory medicines, and even on occasion a cortisone injection into the area of the bursal inflammation, can work wonders with regard to relieving the pain and symptoms of IT band syndrome. Fortunately, surgery is rarely needed for this entity.