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Knee Articles

Meniscal Tears Anterior Cruciate Ligament (ACL) Tear Posterior Cruciate Ligament (PCL) Tear Medial Collateral Ligament (MCL) Tear Lateral Collateral Ligament (LCL) Tears Anterior Knee Pain Patello-femoral Pain (Commonly Called Chondromalacia Patella) Patellar Tendinitis (Jumper's Knee) Knee Osteoarthritis Iliotibial Band Friction Syndrome (ITBS) Knee Replacement

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Iliotibial Band Friction Syndrome (ITBS)

The iliotibial band (ITB) is a strong and flat tendonous structure that originates from the gluteus maximus and tensor fasciae latae (TFL) muscles at the hip. It extends down the outside of the thigh and inserts into the outer region of the shin bone just below the knee joint, specifically at Gerdy's tubercle on the lateral condyle of the tibia.

Iliotibial band friction syndrome, also known as ITBS or iliotibial band syndrome, refers to the inflammation and painful irritation of the iliotibial band as it passes over the lateral epicondyle of the femur, which is located just above the outer part of the knee joint.

ITBS commonly occurs due to repetitive bending and straightening of the knee, often seen in long-distance runners who perform hundreds to thousands of knee movements during endurance runs. Cyclists may also develop ITBS as a result of poor bike setup, while fast-growing teens have reported experiencing this condition as well.

The syndrome is typically caused by a combination of factors that stress the ITB, including

abnormal hip, knee, and foot mechanics (such as excessive pronation) during running
repetitive overuse (such as rapidly increasing running mileage)
poor hip muscle strength and endurance
limited flexibility, worn-out shoes
training on uneven surfaces, and improper bike fit for cyclists

Recent clinical research suggests that hip weakness may not be a direct cause of ITBS in runners, although further studies are needed. However, hip weakness is commonly observed in teenagers.

Conservative treatment is recommended. A physical therapist will evaluate walking and running patterns (gait), bike fit, flexibility, strength, knee and foot mechanics. Treatment usually consists of patient education, rest, stretching, strengthening, a possible change of running shoes, and ice for acute episodes of inflammation.

Possible Treatments

Active Assistive Range of Motion

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