What is IT Band Syndrome?

ITB Syndrome (Iliotibial friction syndrome) is one of the most common causes of "Runner's Knee" and can account for up to 22% of overuse injuries in runners. Being an overuse injury, it is caused by repeated trauma rather than a specific incident.

What is the Iliotibial Band?

The ITB, or iliotibial band, is a long, thin band of fascia that runs down the outside of your thigh. At the top of your thigh it is attached to your Tensor Fascia Latae (TFL) muscle, and Gluteus Maximus and at the bottom it attaches to your tibia (lower leg bone) and femoral condyle on lower outside portion of the thigh bone. 

What Causes ITB Syndrome?

Essentially ITB friction syndrome is caused by altered running biomechanics due to underlying muscular imbalances.Your biomechanics can alter due to a muscle imbalance (weakness or tightness), fatigue and ground impact issues.

The most common causes include: poor biomechanics (running technique); particularly inwards rolling knees and hips, Weak hip / gluteal muscles, weak hip rotators, weak inner quadriceps, weak core muscles, poor foot arch control, Worn out or unsuitable runners, sudden increase in mileage for training, excessive hill training (particularly downhill), endurance running (training for ½. and full marathons, ultra-marathons)

What are the Symptoms of ITB Syndrome?

There are varying degrees of severity of ITB Friction Syndrome. The most common symptoms include: Sharp or burning pain just above the outer part of the knee, Pain that worsens with continuance of running or other repetitive activities, Swelling over the outside of the knee. Pain during early knee bending, Gradual onset of symptoms which if they persist for greater than 4 weeks can cause major sport or activity interference.

The ITB attaches to a bony protuberance (femoral condyle) on the outside of the knee. It slides forwards and backwards across this bony point with movement. This repetitive sliding can create excess friction, especially when the knee is bent at 30 degrees, which commonly happens just as your foot strikes the ground in running. This region of 30 degrees of knee flexion is called an “Impingement Zone” or pinching of irritated structures over the outside of the knee, thereby producing ITB Friction Syndrome.