Iliotibial Band Syndrome

The iliotibial (IT) band, also known as the iliotibial tract or Maissiat’s band, is a group of fibers that run along the upper leg, from the hip to the top of the shin.

The IT band helps to extend, abduct and rotate the hip as well as stabilize and move the side of the knee.

IT band syndrome occurs when the IT band becomes tightened and begins to rub against the outside of the knee, leading to pain and swelling.

Symptoms of Iliotibial Band Syndrome

Signs of the condition may include:

• Pain when running or engaging in activities that use the outside of the knee
• A clicking sensation where the band rubs against the knee
• Pain after exercise
• Tenderness in the knee
• Tenderness in the buttocks
• Redness and warmth around the outer knee
• Referred hip pain

The pain and swelling intensifies if the individual continues to participate in the physical activity.

Risk Factors for IT Band Syndrome

The risk factors for developing IT band syndrome include:

• Pre-existing iliotibial band tightness or prior injury
• Repetitive activities such as running and cycling
• Weak hip, gluteal, and abdominal muscles
• Excessive walking or running on a track or uphill
• Weakness or lack of flexibility
• Knee arthritis
• Excessive sitting
• Weak knee extensor, knee flexors, and hip abductors
• Unbalanced leg lengths
• Bowlegs
• Flat feet

Cyclists, runners, hikers, basketball players, soccer players and weightlifters are at greater risk of developing IT band syndrome.

Making the following mistakes in training can lead to IT band syndrome:

• Improperly warming up or cooling down
• Excessive exercise
• Straining the body
• Insufficient rest between workouts
• Training on the wrong surfaces
• Wearing improper shoes
• Incorrect bicycle fitting
• Poor form
• Suddenly increasing training

Diagnosing IT Band Syndrome

Patients experiencing symptoms of IT band syndrome should schedule an appointment with their primary physician. During an initial visit, the physician will review the patient’s medical history, evaluate their symptoms and perform a physical exam.

The physical exam may involve performing certain exercises so that the physician can observe the patient’s movement patterns, strength and stability. The physician will assess the alignment of the pelvis and the tightness of the IT band. An ultrasound, X-ray or MRI scan may be performed to obtain a better picture of the IT band.

Treating IT Band Syndrome

IT band syndrome may be treated with non-steroidal anti-inflammatory drugs (NSAIDs), ice, rest for up to six weeks, daily stretching, exercises to strengthen the muscles, massage, ultrasounds or electrotherapies to reduce tension. Severe or chronic cases of IT band syndrome may require an iliotibial band bursa injection.

What to Expect During an Iliotibial Band Bursa Injection Procedure

The patient will lie down on the procedure table and the anesthesiologist will place a cannula, or plastic needle, into the patient’s hand and administer a sedative. The physician will then cleanse the injection site with an antiseptic and an x-ray machine to ensure the needle is inserted in the correct place. Once the needle is correctly positioned, the local anesthetic and steroid will be injected. The entire procedure will take about 10 minutes.