IT Band Syndrome

The iliotibial band (IT band) is a thick band of fibrous tissue (fascia latae) that runs down the outside of your thigh from your hip down to your knee. Iliotibial band syndrome (ITBS), often called IT band syndrome, is regarded as an overuse injury in which connective tissue rubs against the thighbone.1 ITBS is common in runners and cyclists. Sports such as long-distance running, cycling, tennis, soccer, skiing, weight lifting and aerobics can lead to IT band issues.

What causes ITB syndrome?

A fluid-filled sac called a bursa normally helps the IT band glide smoothly over your knee as you bend and straighten your leg. But if your IT band is too tight, bending your knee creates friction. Your IT band and the bursa can both start to swell, which leads to the pain outside your knee, particularly when the heel strikes the ground, that can radiate into the outer thigh or calf.2

ITBS is often caused by activities where you bend your knee repeatedly, like running, cycling, hiking, and walking long distances. Improper gait from a variety of conditions can also cause IT band issues.

Conditions that contribute to ITB syndrom include:

  • Short Leg Syndrome (SLS)
  • Back Problems
  • Hip Problems
  • Over-pronation (foot rotating inward)
  • Muscle Imbalances
  • Flat Feet/Fallen Arches
  • Knee and Ankle Problems
  • Sudden Increases in Activity Levels
  • Not using the right training techniques
  • Running or training on the wrong surfaces
  • Improper Footwear

How is IT Band Syndrome diagnosed?

Schedule an appointment with us. We’ll then perform a physical examination which may include range of motion tests, such as a Noble Compression Test (a flexibility test) where we’ll see how flexible your IT Band and hip flexors are. We may also arrange x-rays and/or an MRI. An x-ray will rule out calcification or bone spurs in the area. An MRI will identify the inflammation or damaged IT band. It can also determine if there is any other damage in the soft tissue near the iliotibial tract.

Who is more vulnerable to ITBS?

ITBS in women is estimated to be between 16% and 50% and for men between 50% and 81%.3

Treating IT Band Syndrome (ITBS)

For the first week or two, you will need to rest your leg and reduce the inflammation to help relieve pain. Doctors recommend immediate treatment (within the first 24 to 72 hours) with cold therapy. Wrap an ice pack in a towel and put it on the outside of your knee for 10-15 minutes at a time. Cold therapy is the safe and natural way to control pain and swelling while minimizing tissue damage. Cold therapy can also reduce, or even eliminate, the need for non-steroidal anti-inflammatory drugs (NSAIDs) that can be harmful to your body.

But, be careful! Just because the pain is gone doesn’t mean you’re healed. Schedule an appointment with us. We’ll run our tests to give you a better idea of where you are in the healing process. Once you’re healed enough, we’ll start the rehab. This is a very important part of your recovery. Otherwise, you could end up with flare ups after getting active again.

How can I avoid ITBS?

  • Allow plenty of time to properly stretch, warm up, and cool down.
  • Give your body enough time to recover between workouts or events.
  • Run with a shorter stride (particularly if you’re running downhill).
  • Run on flat surfaces or alternate which side of the road you run on.
  • Replace your shoes regularly.
  • Stretch your IT band, hip muscles, thigh muscles, and hamstrings often.
  • Use a foam roller to loosen up your IT band.


  1. Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin M. Is iliotibial band syndrome really a friction syndrome? J Sci Med Sport. 2007 Apr;10(2):74-6; discussion 77-8. doi: 10.1016/j.jsams.2006.05.017. Epub 2006 Sep 22. PMID: 16996312.
  2. Physical Medicine and Rehabilitation for Iliotibial Band Syndrome Differential Diagnoses. 2016. (accessed on 26th of Jul 2018).
  3. van der Worp MP, van der Horst N, de Wijer A, Backx FJ, Nijhuis-van der Sanden MW. Iliotibial Band Syndrome in Runners. Sport Medicine, 2012;42(11):969-92.