Iliotibial Band Syndrome refers to the symptoms that arise when the iliotibial band (ITB) is irritated from rubbing against the lateral femoral epicondyle, which is the bone on the outside of the knee. It is generally viewed as an overuse injury that is most often seen in endurance athletes that are involved in sports such as running or cycling.
The iliotibial band is a wide sheath of fibrous tissue that arises from outside border of the most prominent bone of the pelvis, known as the iliac crest, then runs down over the hip and thigh until it connects to the bone at the outer portion of the knee just below the joint. Containing muscle fibers from both the buttocks and hip, the primary functions of the iliotibial band are to assist the hip muscles during movements of the thigh and to stabilize the lateral side of the knee.
The iliotibial band may become inflamed and painful as it rubs against the outside of the lateral femoral epicondyle with activities that involve excessive bending and straightening of the knee. This kind of movement is associated with sports like running and cycling. Additionally, iliotibial band syndrome can be the result of other issues including flawed training habits, abnormalities in feet or leg anatomy, or muscle imbalances.
The most common symptom of iliotibial band syndrome is pain along the outside of the knee, which is sometimes accompanied by a clicking sensation. Other symptoms of the condition may include inflammation, stinging just above the knee or along the length of the ITB, and pain that intensifies with activity. Pain may be most severe and radiate from the knee up to the hip when the heel strikes the ground with walking or running. Flexing the knee during such things as going up or down steps can also cause pain. The condition is typically progressive and if left untreated often advances to the point where the pain becomes debilitating.
The diagnosis of ITB friction syndrome is based on history and clinical examination. An MRI may show a partial thickening of the iliotibial band.
The initial treatment for iliotibial band syndrome is conservative and involves controlling the inflammation and pain, rest, a modification of activities, physical therapy, and the correction of underlying problems if present. Most often the condition will respond to these measures. If adequate relief has not been achieved, a corticosteroid injection into the area can be helpful. In cases where conservative therapy has not worked and severe symptoms persist, surgical options may be considered.