Definition

Iliotibial Band Syndrome is one of the leading causes of lateral knee pain in runners. The iliotibial band is a thick band of fibrous tissue on the outside of the thigh, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running, moving from behind the femur to the front of it during the gait cycle. The continual rubbing of the band over the end of the femur, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed and irritated.

Symptoms

The symptoms range from a stinging sensation just above the knee joint on the outside of the knee or along the entire length of the iliotibial band to swelling at the point where the band moves over the femur. The pain may not occur immediately, but may worsen during activity and persist afterward.  A single workout of excessive distance or a rapid increase in weekly mileage can aggravate the condition.

Causes of Injury

• Running on a banked surface, such as the shoulder of a road or on a track, causes the inside leg to bend slightly inward and causes extreme stretching of the band against the femur.
• Overpronation.
• Running excessive distances or increasing mileage too quickly.
• Anatomical abnormalities such as bowlegs, tightness along the iliotibial band and leg length discrepancies.

Short Term Treatment

• Decrease mileage or cease activity.
• Ice knee after activity.
• Alternate running direction on a pitched surface.
• Stretching to tolerance and/or massage.
• ITB strap worn just above the knee.

Long Term Treatment

• Light stretching and a thorough warm-up before running.  Stretch again afterwards.
• Strengthening exercises for the quadriceps femoris and gluteus medius muscles can help support the leg, thus lessening the load on the ITB. 
• Alternate running direction on a pitched surface.
• Stretching to tolerance.

Long Term Treatment

• Stretching, especially before working out, to make the band more flexible and less susceptible to injury.
• Massage and rolling along the length of the IT Band.