Iliotibial Band Syndrome

(IT Band Friction Syndrome; ITBFS; ITBS)


Iliotibial band syndrome (ITBS) is an overuse injury. The iliotibial band (ITB) is a thick band of fibrous tissue. It runs from the hip down the outside of the thigh and attaches to the tibia. The tibia is the large bone of the lower leg.
Tendons of the Lateral Knee
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ITBS is caused by repetitive friction or rubbing of the iliotibial band against the bone on the outer side of the knee. This excessive rubbing can irritate the ITB and/or the tissue underneath.Causes of the excessive friction include:
  • Structural abnormalities, such as a short, tight IT band
  • Problems related to the foot, ankle, or hip
  • Opposing muscle imbalances, such as the quadriceps stronger than hamstrings
  • A prominent lateral femoral epicondyle, the bony structure on the outer side of the knee
  • Inward rotation of the leg
  • Angle where knee flexes
  • Legs of different lengths
  • Bowlegs

Risk Factors

Factors that increase your risk of getting ITBS include:
  • Certain sports with repetitive motions, such as running and cycling
  • Incorrect training technique
  • Increasing cycling or running mileage too quickly
  • Running up and down hills
  • Overtraining
  • Using damaged or worn out equipment or footwear
  • Wearing improper shoes for a sport or athletic activity
  • Athletic equipment that is not properly fit to the user, such as a bicycle


Symptoms of ITBS include:
  • Dull aching or burning sensation on the outside of the knee during or after activity
  • Sharp stabbing pain on the outside of the knee during or after activity
  • Pain that shows up in the hip, known as referred pain
  • Progressive, worsening pain
  • Snapping, creaking, or popping when the knee is bent and then straightened

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