The Iliotibial (IT) band is the thick sheath of connective tissue that runs from the hip bone (femur) down the outside of the thigh and attaches to the outside of the shin bone(tibia). It acts to extend (straighten) the leg and abduct the hip (move it sideways). As this band passes over the bony part on the outside of the knee, it causes friction which leads to pain. Iliotibial band syndrome is sometimes referred to as runners knee or Iliotibial band friction syndrome which all mean the same thing.

Symptoms of Iliotibial band syndrome are:

  • A burning sensation on the outside of the knee (most common), or along the entire sheath.
  • Swelling of the knee
  • Pain worsens when the foot strikes the ground
  • Pain when running downhill
  • Weakness in hip abduction
  • Pain when the knee is extended (straightened).

Causes of this type of injury are:

  • Over-pronation (foot rolls inward and toes turn outward)
  • A tight or wide IT band, bow legs
  • Weak hip muscles
  • Overuse
  • Excessive hill running or increasing mileage too quickly
  • Leg-length discrepancy
  • Insufficient warm-up or cool down

A rehabilitation program and changes to your practice routine can bring about positive results. Rehabilitation will consist of therapeutic massage and/or dry needling to relieve tightness in the IT band and get rid of trigger points in the gluteus (hip muscles). Strengthening of the hip abductors (muscles that move the hip outwards) are also critical to relieving this condition. The athlete can rest and apply cold therapy to the knee to reduce pain. Minimizing downhill running or eliminating it altogether will also be helpful. Wearing an orthotic support to reduce over-pronation is often recommended.

IT band syndrome is a condition that takes a long time to go away, months or even more than a year. Even after symptoms appear to cease, you still need to continue with prescribed exercises. It is therefore imperative that you consult a physiotherapist to help you get on the road to recovery. He/she will guide you in the proper way to stretch – you should not overstretch – and perform the strengthening exercises.