The iliotibial band (ITB) is a tendon that runs along the outside of your leg. It connects from the top of your pelvic bone to just below your knee. A tendon is thick elastic tissue that connects muscle to bone. Iliotibial band syndrome occurs when the ITB becomes swollen and irritated from rubbing against the bone on the outside of your hip or knee.
There is a water-filled sac, called a bursa, between the bone and the tendon on the outside part of your leg. The rubbing of the tendon can cause pain and swelling of the bursa, the tendon, or both. This injury often affects runners and cyclists. Bending the knee over and over during these activities can create irritation and swelling of the tendon.Other causes include:
If you have ITB syndrome you may notice:
Your doctor will examine your knee and move your leg in different positions to see if your ITB is tight. Usually, ITB syndrome can be diagnosed from the exam and your description of the symptoms. If imaging tests are needed, they may include any of the following:
If you have ITB syndrome, treatment may involve any of the following:
Most people do not need surgery, but if other treatments do not work, surgery may be recommended. During surgery, part of your ITB, the bursa, or both will be removed. Or, the ITB will be lengthened. This prevents the ITB from rubbing against the bone at the side of your knee.
At home, follow these measures to help reduce pain and swelling:
For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store.
Try running or cycling shorter distances than you usually do. If you still have pain, avoid these activities completely. You may need to do other exercises that do not irritate your ITB, such as swimming. Try wearing a bandage or knee sleeve to keep the bursa and ITB warm while you exercise.
A physical therapist (PT) will provide a custom treatment plan for your specific injury so you can return to normal activity as soon as possible. They will recommend ways to change how you exercise to prevent problems. You may also be fitted for arch supports (orthotics) to wear in your shoes.
Once you can do stretching and strengthening exercises without pain, you can gradually begin running or cycling again. Slowly build up distance and speed.
Your PT will give you exercises to help stretch your ITB and strengthen your leg muscles. Before and after activity:
The best way for the tendons to heal is to stick to a care plan. The more you rest and practice physical therapy, the quicker and better your injury will heal.
Call your health care provider if pain gets worse or does not get better in a few weeks.
For any orthopedic sports medicine condition, including hip-specific issues, call 1-855-NH-SPORT to schedule an appointment with one of our orthopedic sports medicine specialists.