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Iliotibial band syndrome

Published: 16 July 2019 - Clinical Conditions

Image of female clutching knee

Iliotibial band syndrome is a common overuse injury experienced by runners, bike riders, rowers, weight lifters and anyone who repetitively works their leg muscles through exercises such as squats.

Most of the early warning signs of Iliotibial band syndrome such as tingling and pins and needles go unnoticed. 

What is the Iliotibial band?

The Iliotibial band (IT band) - pictured right - is made up of fascia (connective tissue) and runs from our pelvis to the tibia, crossing the hip and knee joints. Its role is to stablise the outside of your knee and support it through its range of motion. It is because of the IT band’s ability to stablise the knee as it flexes and extends which often leads to injury. 

Do I have IT band syndrome?

Iliotibial band syndrome usually presents as a sharp or burning pain in the outside of the knee. This is often more noticeable during exercise where the knee is repeatedly flexing and contracting through a range of 30 to 45 degrees.  It is between these angles that the IT band experiences the most compression over the lateral knee joint. This causes friction between your knee bone and IT band.

The pain usually stops once the exercise ends giving the person the impression that there is nothing to worry about. But it’s here where there is potential for further injury.  

What causes Iliotibial band syndrome?

Iliotibial band syndrome arises from a combination of issues including incorrect technique, changed training habits, reduced balance, decreased muscle flexibility and strength and other bio-mechanical imbalances, especially involving the low back, pelvis and hips. 

As we place mechanic demands on our body - running, jumping, pushing or lifting - our muscles and joints all experience different forces and often it is through the incorrect use of our muscles that we experience overuse injuries such as IT band syndrome. 

While it is the role of the IT Band to generate stability for our knees, it is not a suitable long term answer. Instead we need to focus on working and developing dedicated stabilising muscles of our lower limbs. 

How do you manage and prevent IT band syndrome?

An assessment with your physio will help you determine what activities are triggering your IT band injury.

Depending on the extent of your injury or the regularity of its occurrence your physio will also encourage rest from this activity while your body recovers. 

Manipulation and releasing tension in muscles such as the hip flexors, strengthening and activation of supporting muscles including the glutes, and adjusting associated technique (biomechanics) are all strategies used to encourage correct movement pattern through the bent knee during repetitive loading.    

Without biomechanical correction or the required maintenance on out of balance muscle groups, IT band syndrome is likely to return and persist. However as it is an overuse injury, commitment to correcting your technique and building up the supporting muscle groups will reduce the likelihood of reaggravation.