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Iliotibial Band Syndrome

Iliotibial Band Syndrome is one of the leading causes of lateral knee pain in runners. The iliotibal band is a superficial thickening of tissue on the outside of the thigh, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running, moving from behind the femur to the front of it during the gait cycle. The continual rubbing of the band over the bone, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed or the band itself may become irritated.


The symptoms range from a stinging sensation just above the knee joint on the outside of the knee or along the entire length of the iliotibial band to swelling to a thickening of the tissue at the point where the band moves over the femur. The pain may not occur immediately, but will worsen during activity when the foot strikes the ground if you overstride or run downhill, and may persist afterward. A single workout of excessive distance or a rapid increase in weekly mileage can aggravate the condition.

Causes of Injury

Iliotibial Band Syndrome is the result of both poor training habits and anatomical abnormalities.

  • Running on a banked surface, such as the shoulder of a road or an indoor track, causes the downhill leg to bend slightly inward and causes extreme stretching of the band against the femur.
  • Inadequate warm-up or cool-down.
  • Running excessive distances or increacing mileage too quickly can aggravate or cause injury.
  • Anatomical abnormalities such as bowlegs or tightness about the iliotibial band.

Short Term Treatment

To treat functional problems resulting from poor training:

  • Decrease mileage.
  • Ice knee after activity.
  • Alternate running direction on a pitched surface.
  • Lateral sole wedge to lessen pressure on the knee.
  • Stretching to tolerance

Long Term Treatment

To treat structural abnormalities such as a natural tightness in the band:

  • Stretching, especially before working out, to make the band more flexible and less susceptible to injury
  • In extreme cases, surgery to relieve tightness in the band

Both structural and functional problems need to be considered when treating Iliotibial Band Syndrome.