The symptoms of iliotibial band syndrome (IT band syndrome) are pain, aching or burning on the outside of your knee joint. In the initial stages, the pain tends to ease after you start to exercise, but as the condition worsens exercising may lead to an exacerbation of symptoms. You may also develop warmth or redness on the outside of the knee, pain extending up or down your leg and a clicking, popping or snapping sensation on the outside of your knee.
What is the iliotibial band?
The iliotibial band is a tendon. This thick fibrous band of tissue runs along the outside of your thigh, from your knee to your pelvic bone, and works in conjunction with the ligaments to stabilise your knee joint. If a repetitive activity causes your IT band to tighten, it may start to rub against your hip or knee bone, causing the tendon to become inflamed and painful. The pain may range from mild to severe, depending on the extent of the inflammation, and it is likely to worsen without sufficient rest or treatment. You may develop iliotibial band syndrome in one or both legs.
What causes iliotibial band syndrome?
Iliotibial band syndrome is an overuse injury associated with making repetitive movements. It is particularly common among runners and cyclists, but it can occur in other athletes too, particularly those whose sport involve repeatedly running, such as rugby and tennis players, footballers, basketball players and hockey players. It can also affect skiers.
Certain factors make it more likely that you will develop the condition, including having weak hip or knee muscles, tightness in the iliotibial band, different leg lengths or knee arthritis. It is more common in women than in men.
Other contributory factors include:
- overusing the leg muscles by running for extended periods
- pushing yourself too hard and not resting when you are tired
- suddenly increasing the intensity or duration of your training
- poor running technique or running in worn-out or ill-fitting running shoes
- running on uneven ground or sudden changes in the ground surface
- failing to build up your fitness gradually or to warm up or cool down properly after exercising.
How is iliotibial band syndrome diagnosed?
Your doctor will ask about your symptoms and when they occurred. They will carry out a physical examination, which will include asking you to move your knee and hip. The doctor will be checking for the location and severity of any pain, when it is worse and when it improves, as well as assessing for any grating sensation when you move your knee or hip. If iliotibial band syndrome is suspected you may need an ultrasound scan to assess how the iliotibial band moves when you flex and extend your knee. Sometimes you may also require an MRI scan to check for other injuries such as a knee meniscal tear.
What are the treatments for iliotibial band syndrome?
Treatment for the condition will depend on its severity and the symptoms you are experiencing. For mild conditions, the primary treatment is rest to allow your damaged iliotibial band to heal. You can take anti-inflammatories or painkilling medication to relieve the pain and a physiotherapist can recommend stretching and strengthening exercises to help you lengthen the iliotibial band and ease your symptoms. In some cases, an injection of corticosteroids into the damaged area can help to relieve inflammation. Rarely iliotibial band syndrome is so severe that you may require surgery. This will normally only be recommended after all other, less invasive treatments have been tried. It is important not to ignore the symptoms of iliotibial band syndrome as they are likely to increase without treatment of some kind. In some cases, iliotibial band syndrome can lead on to patellofemoral pain syndrome (PFPS or jumper’s knee), which is pain around and under the kneecap. Like iliotibial band syndrome, PFPS is an overuse injury that can develop gradually and worsen over time.
It normally takes four to six weeks to recover from iliotibial band syndrome after treatment but it can be longer depending on the severity of any symptoms.
Reducing the chances of developing iliotibial band syndrome
It is not always possible to avoid developing iliotibial band syndrome, particularly if you are involved in high impact sports like running or skiing. However, taking a common sense approach may decrease the likelihood of sustaining a serious injury. We recommend building up your fitness gradually and avoiding any sudden increases in the duration and intensity of your workout. Wear good, well-fitting running shoes and always warm up and cool down properly beforehand.
If you have persistent knee pain and are concerned you may have iliotibial syndrome or patellofemoral pain syndrome, contact us for advice on diagnosis and treatment.
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