IT Band Syndrome

What Is Iliotibial Band Syndrome?

ITB syndrome is a condition which causes pain at the outside, lateral, aspect of the knee. The Iliotibial band is a made up of strong connective tissue called fascia that runs from the hip to the outside of the knee and the bottom part of the band may become irritated, inflamed and painful.


What Are The Causes Of ITB Syndrome?

ITB syndrome is caused when the bottom part of the band repeatedly rubs over the lateral femoral epicondyle in instances of repetitive knee flexion (bending) and extension (straightening). This often occurs in runners and cyclists. This may develop due to poor hip strength and stability, allowing the knee to collapse inward and causing the band to impact on the femur.


What Are The Signs And Symptoms Of ITB?

Lateral (outside) knee pain, tenderness of the ITB and lateral knee, tightness and pain occurring along the outside of the thigh, increased knee internal rotation, hip muscle weakness, lateral sitting patella, decreased patellar and knee joint mobility


What Are The Risk Factors Of ITB?

Poor biomechanics, hip muscle weakness, muscular tightness in the lower leg, lack of cross training, or cycling and running.


How Is Iliotibial Friction Syndrome Syndrome Diagnosed?

PTs diagnose ITB syndrome by identifying the signs and symptoms (listed above) and by conducting special PT tests and functional assessments.


What Are The Possible Treatments For ITB Syndrome?

Manual therapy to decrease inflammation, improve muscle flexibility surrounding the ITB (the ITB itself cannot be stretched, but the tissues underneath it and surrounding it must exhibit good texture, length, and flexibility). Joint mobilization to correct patellar malalignment and improve patellar mobility. Correcting ROM deficits of the hip rotators via manual stretch and joint mobilization. Strengthening and stabilization training for the lower extremity muscles, especially the hips. Return to sport specific exercise and plyometrics.


Are There Preventative Steps Or Measures To Avoid ITB?

Maintaining good flexibility of the lower extremities, participating in cross-training for athletes.


What Are The Risks If ITB Syndrome Is Left Untreated?

It could lead to chronic knee pain or chronic hip pain. May lead to increased risk for knee or hip arthritis. Underlying poor biomechanics can contribute to increased risk for other lower extremity injuries in the future.


Are There Other Related Conditions To ITB Syndrome?

Symptoms may mimic those of PFPS, lateral meniscus or LCL injury, knee joint arthritis


Key Takeaways About ITB Syndrome

-It is important for athletes to participate in cross training to maintain good hip muscle strength and stability. Running and cycling occur within the sagittal plane and lack of training in other planes can lead to hip weakness and biomechanical breakdown.
-The poor biomechanical patterning that contributes to ITB syndrome can cause a multitude of other painful conditions
-It is important to investigate how the joints above and below the ITB contribute to the condition, including the foot, knee, and hip.


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