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What is Iliotibial Band (ITB) Syndrome?

What is Iliotibial Band (ITB) Syndrome?
Pain along the outside of the knee can be debilitating to an athlete causing severe pain during running, squatting, stair climbing, or cycling activities. The iliotibial band (ITB) is a thick connective tissue that runs from the outside of the iliac crest (pelvic bone),...

Pain along the outside of the knee can be debilitating to an athlete causing severe pain during running, squatting, stair climbing, or cycling activities. The iliotibial band (ITB) is a thick connective tissue that runs from the outside of the iliac crest (pelvic bone), down the thigh and past the knee joint and has attachments to the shinbone, kneecap and surrounding muscles. ITB syndrome occurs commonly during activities such as running and cycling that involve repetitive bending and straightening of the knee. The ITB functions to assist in stabilizing the knee; however, inflammation occurs if repetitive bending and straightening of the knee leads to irritation of the underlying bursa or to the ITB itself due to rubbing against a bony portion of the femur or thigh bone. ITB syndrome can occur as a result of training errors, structural abnormalities, or mechanical imbalances. Running on a canted surface creates a leg length discrepancy placing more stress on the hip and pelvis. Overtraining or poor shoe wear can contribute to onset of symptoms as well. Structural issues such as a leg length difference caused by scoliosis or a degenerative process can cause pain, and mechanical issues such as a weak core or imbalances in strength and flexibility in the lower extremities can result in tightening of the ITB. Cyclists with poor posture or those who ride a bike that is not properly fitted often develop ITB syndrome. Symptoms include pain along the outside of the knee that is worse when the heel hits the ground when walking or running or when swinging the leg through during gait. Tenderness and swelling may occur at the lateral knee. Conservative treatment includes rest, physical therapy designed to address the mechanical imbalances, and adjustments to current training program. Physician consultation may be needed to rule out other injuries such as lateral meniscus tear or lateral collateral ligament injury.

Cindy Shimamoto, PT, OCS, COMT

Center Manager – Creve Coeur

SSM Physical Therapy

12382 Olive Blvd.

Creve Coeur, MO  63141

314-453-9675 (phone)

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St. Louis MO 63117

Advanced Orthopedics & Sports Medicine