Iliotibial Band Friction Syndrome

By Drew Heideman, MPT, ATC, PES

Iliotibial Band Friction Syndrome

By: Drew Heideman, MPT, ATC, PES

The Iliotibial Band is a longitudinal fibrous reinforcement of the fascia latae in a knee muscle. Iliotibial Band Friction Syndrome (ITBFS) is an inflammatory non-traumatic overuse injury of the knee predominately affecting long-distance runners. In addition, ITBFS may be caused by a multitude of factors. This includes training errors, worn out running shoes and/or lower leg misalignments. Knee pain usually occurs at a particular point in each training run, and is more pronounced shortly after the foot contacts the ground surface. Attempting to run through the pain will intensify the symptoms. This will eventually cause the athlete to shorten his or her stride or slow to a walk.

The IT band can get tight and cause anterior knee pain.

Illustration of the IT Band Anatomy.

Diagnosing ITBFS

Your therapist or physician can diagnose by using the modified Ober’s test. With the patient lying on the non-injured side, the practitioner raises the upper hip and thigh into slight abduction, extends the hip and thigh, and allows the leg to drop into adduction while stabilizing the pelvis and thigh. In conclusion, the test is positive for ITBFS if the thigh does not descend to or beyond 10 degrees.

Picture of the Iliotibial Band location on the leg

Iliotibial Band Location on Leg

Symptoms of ITB Friction Syndrome

Sharp pain on the outer aspect of the knee that can radiate into the outer thigh and/or calf.

Physical Therapy for ITB Syndrome

A home exercise program on a foam roller can be taught for myofascial release. Also, combination ultrasound and muscle stimulation therapy will help restore normal muscle tone along with stretching and strengthening exercises. Iontophoresis with dexamethasone along with ice can also be used to decrease inflammation.

Strengthening the VMO of the quad muscle group is so important with this condition.  The VMO often is weak in patients with ITB Syndrome.  Please read this article on how to strengthen the VMO of the Quad.

  • Runners Home Program:
    • A 15-to-20 minute flexibility routine with a resistance band.
    • Stretching of the hamstrings, quadriceps and IT band.
  • iliotibial band ITB stretch with belt for IT Band Syndrome

    Iliotibial band ITB stretch with belt

    seated hamstring stretch in chair

    Seated hamstring stretch in chair

    • Apply a cold pack to lateral (outside) aspect of the knee for 20 minutes.
  • If these do not help, you might want to consider coming in to see a physical therapist. 
  • Related Articles: Concentric and Eccentric Contractions and IT Band Stretching. 

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