Knee > Iliotibial 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 inflamed.


Following are some common causes of ITB friction syndrome:

   Running 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.

   Inward rotation (overpronating) of the feet, or having one leg that is longer than the other.

   A sudden increase in training intensity or duration.

   Training in sneakers with uneven wear.

   Running on uneven surfaces, such as an uneven road or a banked indoor track.

Orthopedic Evaluation  

There are usually three parts to an orthopedic evaluation: medical history, physical examination, and tests your physician may order.


Since 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.


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.

   Imaging techniques

Non-Operative Treatment
Therapeutic Injection (Corticosteroid)
Surgical Release

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