ITB Syndrome Explained

The iliotibial band (ITB) is a thick band of connective tissue that runs down the outside of your thigh from the pelvis to the knee. As you bend and straighten your knee, the ITB passes across a bony prominence (lateral epicondyle) on the outside of the knee. If your ITB is tight or you do an activity that involves a lot of knee bending and straightening (e.g. cycling and running up and down hills) you can develop friction on the outside of the knee, which may cause ITB inflammation and pain.  This is called ITB syndrome.

ITB syndrome involves pain generally felt on the outside of the knee. The pain may radiate up the thigh or down the outside of the shin. Usually, the pain is only present during activity and then settles with rest. Sometimes discomfort can be felt going up or down stairs, particularly after running or cycling.

ITB syndrome often responds well to physiotherapy. Firstly, it is important to reduce the inflammation. Relative rest from the aggravating activity and icing the area can be very helpful. Stretching of the ITB and the muscles that attach to it can help to relieve tension. Your physiotherapist can help with this and the foam roller (see our previous topic “Foam Roller”) can also be used once the initial inflammation has settled. Any biomechanical abnormalities of the lower limb and foot will need to be addressed. This includes ensuring that you are wearing appropriate footwear. Often people have gluteus medius weakness (one of the buttock muscles) which, when strengthened appropriately, can help reduce the stress on the outside of the knee.

It is important to note that pain on the outer aspect of the knee is not always from the ITB. There are other structures that may be causing your pain, including the lumbar spine which can refer into the knee. It is best to discuss your pain with your physiotherapist so they can assess you and guide you in the right direction so you can get back up and running or cycling!


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