Iliotibial band syndrome


A common injury to the knee, generally associated with running, cycling, hiking or weight-lifting, and squats.

One of the leading causes of lateral knee pain in runners.

Endurance athletes are especially prone.

Athletes who suddenly increase their level of activity often develop ITBS.

The iliotibial band is a thick band of fascia on the lateral aspect of the knee.

It is due to inflammation of the iliotibial band, a thick band of fibrous tissue that runs down the outside of the leg.

The iliotibial band begins at the hip and extends to the outer side of the tibia just below the knee joint.

The band functions with several thigh muscles to provide stability to the outside of the knee joint.

It extends from the outside of the pelvis, over the hip and knee, and inserting just below the knee.

The band is essential to stabilize the knee during running, as it moves from behind the femur to the front of the femur during activity.

Repetitive rubbing of the band over the lateral femoral epicondyle, combined with the repeated flexion and extension of the knee during activity may cause the area to become inflamed.

Symptoms range from a stinging sensation just above the knee joint, to swelling or thickening of the tissue in the area where the band moves over the femur.

When inflamed, the iliotibial band does not glide easily, and pain is the result.

Burning sensation just above the knee joint is felt on the outside of the knee or along the entire length of the iliotibial band.

The irritation occurs over the outside of the knee joint, at the lateral epicondyle–the end of the femur.

Pain may not occur immediately with activity, but may increase over time.

Pain is most commonly felt when the foot strikes the ground.

Pains may persist after activity ceases.

Pain may be present above and below the knee, where the ITB attaches to the tibia.

ITBS can result from training exercises, anatomical abnormalities, or muscular imbalances.

Running on a banked surface causes the downhill leg to bend slightly inward, causing stretching of the band against the femur.

Related to inadequate warm-up or cool-down procedures.

Associated with excessive up-hill and down-hill running.

Associated with running up and down stairs, and hiking long distances.

Associated with lower leg rotation due to over-pronation, excessive foot strike force, uneven leg length

Associated with weak hip abductor muscles.

Management includes: rest to control inflammation, icing relieves the pain, and stretching.

Anti-inflammatory agents are frequently used to help decrease inflammation.

When acute symptoms are controlled, therapy should increase flexibility and strength of the hip and knee.

Rehabilitation focuses on both hip and knee function, as the iliotibial band requires proper mechanics of both of these joints for normal function.

Corticosteroid injection into the area of inflammation be attempted beneficial.

Surgical management is rarely used.

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