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ITB (Iliotibial Band) Syndrome

The iliotibial band (ITB) is a flat tendon that runs on the outside of the thigh from the side of the hip to the outside of the knee.

When the knee flexes and extends, the ITB tendon normally glides smoothly over the outer bony part of the knee and attaches near the kneecap. If the ITB rubs over the bony part of the knee with more force or frequency inflammation may start. This is a type of tendonitis (inflammation of the tendon). There also is a small bursa, or fluid filled cushion that becomes inflamed, causing bursitis as well.

With overuse, or new activities (such as a new running or cycling program) the ITB may become irritated near the outside of the knee leading to the diagnosis of ITB syndrome. This is especially likely to happen if the tendon is too tight (not enough stretching), or certain hip muscles are weak.

A painful snapping sensation with walking or running is felt on the outside of the knee, and it may be tender to the touch.

Diagnosis of ITB syndrome is usually made in the exam room by a health care professional by moving the knee, and pushing on the ITB near the knee. X-rays, MRIs etc. are generally not necessary unless unusual or other symptoms are present.

Normally, ITB syndrome improves with rest and ice, and gradual stretching. If not, physical therapy and anti-inflammatory medications (“NSAIDs”) may be helpful. Cortisone shots and surgery are rarely necessary.

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