Iliotibial Band Syndrome

What is iliotibial band syndrome?

Iliotibial band syndrome is inflammation and pain on the outer side of the knee. The iliotibial band is a layer of connective tissue. It begins at a muscle near the outer side of your hip, travels down the outer side of your thigh, crosses the outer side of the knee, and attaches to the outer side of your upper shin bone (tibia).

How does it occur?

Iliotibial band syndrome occurs when this band repeatedly rubs over the bump of the thigh bone (femur) near the knee, causing the band to be irritated. This most often occurs in running.

This condition can result from:

• having a tight iliotibial band
• having tight muscles in your hip, pelvis, or leg
• your legs not being the same length
• running on sloped surfaces
• running in shoes with a lot of wear on the outside of the heel

What are the symptoms?

The symptom is pain on the outer side of the knee.

How is it diagnosed?

Your healthcare provider will examine your knee and find tenderness where the band passes over the bump on the outer side of your knee. Your iliotibial band may be tight.

How is it treated?

Treatment includes the following:

• Place an ice pack over your iliotibial band for 20 to 30 minutes every 3 or 4 hours for 2 to 3 days or until the pain goes away.
• You can also do ice massage. Massage your knee with ice by freezing water in a Styrofoam cup. Peel the top of the cup away to expose the ice and hold onto the bottom of the cup while you rub ice over your knee for 5 to 10 minutes.
• Take an anti-inflammatory medicine, according to your healthcare provider's prescription. Adults aged 65 years and older should not take non-steroidal anti-inflammatory medicine for more than 7 days without their healthcare provider's approval.
• Do the stretching and strengthening exercises recommended by your healthcare provider or physical therapist.

Your provider may give you an injection of a corticosteroid medicine to reduce the inflammation and pain.

While your knee is healing, you will need to change your sport or activity to one that does not make your condition worse. For example, you may need to bicycle instead of run.

How long will the effects last?

The length of recovery depends on many factors such as your age, health, and if you have had a previous injury. Recovery time also depends on the severity of the injury. A mild injury may recover within a few weeks, whereas a severe injury may take 6 weeks or longer to recover. You need to stop doing the activities that cause pain until your iliotibial band has healed. If you continue doing activities that cause pain, your symptoms will return and it will take longer to recover.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities will be determined by how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely return to your normal activities when, starting from the top of the list and progressing to the end, each of the following is true:

• your injured knee can be fully straightened and bent without pain
• your knee and leg have regained normal strength compared to the uninjured knee and leg
• you are able to walk or jog straight ahead without limping

How can I prevent iliotibial band syndrome?

Iliotibial band syndrome is best prevented by warming up properly and doing stretching exercises before sports or other physical activity.