Band Friction Syndrome
What is the Iliotibial Band?
The iliotibial band (ITB) is a thick band of
tissue that runs along the outside of the thigh from
the hip to the point where the shinbone (tibia) connects
to the knee. It holds your leg straight when you stand,
and takes pressure off your thigh muscles.
Iliotibial band friction syndrome is an overuse injury
that occurs when the ITB rubs across the outside of
the knee, causing pain, irritation, and swelling. The
pain actually stems from the bursa sac, a small, fluid-filled
sac that lies underneath the ITB where it inserts into
the knee. When the band is pulled too tight from repeated
flexion and extension of the knee, the bursa becomes
Following are some common causes of
ITB friction syndrome:
and cycling, which involve repetitive flexion and extension
of the knee. Weight lifters who do a lot of squatting
and standing are also at risk.
rotation (overpronating) of the feet, or having one
leg that is longer than the other.
sudden increase in training intensity or duration.
in sneakers with uneven wear.
on uneven surfaces, such as an uneven road or a banked
There are usually three parts to an
orthopedic evaluation: medical history, physical examination,
and tests your physician may order.
ITB friction syndrome shares some symptoms with other
knee problems, it is important to be as accurate as
possible in describing your symptoms to your doctor,
including if your knee has been previously injured.
Physicians also typically ask about other conditions,
such as diabetes and allergies, and medications currently
being taken. Your physician may also ask about your
physical and athletic goals – information that
will help him decide what treatment might be best for
you in achieving those goals.
| PHYSICAL EXAMINATION
Your physician will check for any
structural abnormalities that can contribute to ITB
friction syndrome, such as leg-length discrepancy or
excessive inward turning (overpronation) of the feet.
He will also check for tenderness by putting pressure
on your hip when it is flexed and extended, bearing
weight and not bearing weight.
Chronic cases of ITB friction syndrome can cause bone
inflammation, which can be diagnosed using a bone scan.
Some surgeons inject a small amount of a local anesthetic,
similar to Novocain that dentists use, to numb the sore
area. If this takes away a significant portion of the
pain, it helps confirm the diagnosis. X-rays or an MRI
may also be obtained.