Causes of Iliotibial (IT) Band Syndrome and Treatment Options

Everything you need to know about iliotibial band syndrome

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The iliotibial (IT) band is a strong, thick band of fibrous tissue that starts at the hip and runs along the outer thigh. It attaches on the outside of the shin bone, or tibia, just below the knee joint. The band works with your thigh muscles to provide stability to the outside of the knee during movement.

IT band syndrome can be triggered by irritation or injury to the IT band through certain exercises, workout practices. It can also result from faulty biomechanics, which is when parts of your body are not properly aligned. There are both at-home and doctor-prescribed treatments available for this condition.

Causes of IT Band Syndrome.

Alexandra Gordon / Verywell

This article will explain the symptoms and causes of IT band syndrome. It will also cover when you should see your doctor, how IT band syndrome is diagnosed, and treatment options.

What Are Symptoms of IT Band Syndrome?

IT band syndrome is a condition most commonly seen in runners, but it can also impact cyclists, those who play sports, and those who are new to working out. Symptoms may include:

  • Knee pain on the outside of the knee that may burn
  • Thigh and hip pain that may ache and burn
  • Pain while exercising
  • Pain that continues after you stop working out

Over time, the pain may become constant and sharp. As the pain becomes more severe, swelling on the outside of the knee may occur.

What Causes Iliotibial Band Syndrome?

IT band syndrome may occur if the IT band gets irritated from rubbing up against bone while it is stretched. It can also occur if the hip or knee bursa, which is a fluid-filled sac that helps with movement, becomes swollen. These conditions can be triggered by:

  • Wearing non-supportive shoes
  • Running downhill
  • Working out too hard
  • Not stretching before working out
  • Knee arthritis, which can cause your knees to move outward even when your feet are touching, also known as bow legs
  • Faulty biomechanics, like foot overpronation, which is when you over-flatten your feet as you move, which can strain your muscles and tendons
  • Muscle tightness in the buttock, hip muscles, and thigh muscles

When Should I See a Doctor for IT Band Pain?

It's important to see your healthcare provider for any knee pain that is severe, worsening, or lasts for more than a few weeks.

In addition to knee pain, seek immediate medical care if you:

  • Are unable to walk comfortably or have knee locking, which is when you are unable to bend your knee
  • Have swelling or skin changes, like warmth or redness
  • Experienced a traumatic knee injury
  • Have a fever

How Is Iliotibial Band Syndrome Diagnosed?

To diagnose IT band syndrome, your doctor will take a detailed medical history. They will ask you questions about the location of your pain, how long you've had symptoms, as well as what tends to make the pain better or worse.

Your doctor will also give you a physical exam. They may do tests that check for pain in specific areas to confirm your diagnosis. Tests may include:

  • The Ober test, where your doctor will move your knee and hip while you are lying on your side
  • The Noble's compression test, where your doctor will move your knee while pressing on the outside of it

Your doctor may also have you do imaging tests, like an X-ray, which checks for bone and joint issues or breaks, or magnetic resonance imaging (MRI), which checks for ligament and joint injuries.

Recap

To diagnose IT band syndrome, your doctor will take a detailed medical history and do a physical examination. Rarely, imaging, like an X-ray, is required to confirm a diagnosis of IT syndrome.

Other Potential Diagnoses

Other diagnoses your doctor may consider include:

  • Patellofemoral stress syndrome, which can cause kneecap and hip pain, and is due to abnormal kneecap rubbing, especially while exercising
  • Lateral collateral ligament tear, which is a ligament tear on the outside of the knee that can lead to knee instability
  • Popliteal tendonitis, which can cause pain or a popping sensation near the back of the knee

What Is the Best Treatment for IT Band Syndrome?

Treating IT band syndrome may include at-home remedies, as well as medication, physical therapy, and in some cases, surgery.

R.I.C.E. Protocol

The R.I.C.E. protocol can be a helpful step in reducing IT band pain.

  • Rest (or Reduce Activity): Whether you have been diagnosed with or suspect iliotibial band syndrome, your first step should be to rest the affected leg.
  • Ice: Place ice, along with a thin towel, on the outside of your knee for 15-minute sessions every two hours to help with pain and relieve inflammation.
  • Compression: If you have been diagnosed with IT band syndrome, talk with your doctor about wrapping an Ace bandage just above your knee. Compressing this area can help stabilize the knee.
  • Elevation: When icing your knee, try to keep your leg raised above your heart.

Medication

Your doctor may recommend taking a nonsteroidal anti-inflammatory (NSAID), such as Advil (ibuprofen) to help with pain.

They may also suggest getting steroid injections to help with pain and inflammation. This treatment may be considered if a person continues to have pain even after trying the R.I.C.E. method and taking an NSAID.

Physical Therapy

When your pain and inflammation improves, you can begin physical therapy. A physical therapist will use different methods to boost leg strength, mobility, and flexibility.

Surgery

Surgery is rarely required to treat IT band syndrome. It's usually only recommended if pain continues after at least six months of trying physical therapy, medications, and the R.I.C.E. method.

How Do I Prevent IT Band Pain?

You can prevent IT band irritation by:

  • Replacing your workout shoes when they no longer feel supportive
  • Running in both directions if running on an uneven course or on a track
  • Stretching before and after working out
  • Increasing your workout intensity over time
  • Training on flat surfaces
  • Limiting running or jogging downhill

Summary

IT band syndrome can cause symptoms such as knee, thigh, and hip pain that may also burn or ache. The pain may worsen over time and lead to swelling.

IT band syndrome may be triggered by certain conditions, running downhill, wearing non-supportive shoes, and not properly stretching.

Your doctor can diagnose IT band syndrome by taking a detailed medical history, giving you a physical exam, and possibly doing imaging tests.

Treatment may include the R.I.C.E. method, medications, physical therapy, and possibly surgery.

A Word From Verywell

IT band pain may improve if you reduce your activity, stretch, and take an NSAID. In order to prevent this pain from coming back, it's important to figure out what caused it.

If you continue to have IT band pain, be sure to speak with your doctor about other treatment options.

Frequently Asked Questions

  • How common is iliotibial band syndrome?

    It's very common among people who are physically active. IT band syndrome is responsible for 22% of all lower leg injuries in athletes.

  • How long does it take to heal from iliotibial band syndrome?

    This depends on many factors, but some people recover within two to eight weeks after resting, stretching, and taking medications.

  • What is a good stretch for the IT band?

    There are lots of ways to stretch the iliotibial band. This simple standing stretch has been found to be especially effective:

    1. Cross your right leg behind your left, both toes pointing forward.
    2. Raise both arms straight overhead and grasp your hands together.
    3. Lean toward your right until you feel a stretch along the outside of your left thigh.
    4. Hold for a count of 30; repeat three times, then switch sides.


  • What kind of running shoes should I choose if I have iliotibial band syndrome?

    There's no one-size-fits-all recommendation for shoes. However, it may be a good idea to see a podiatrist, a foot, ankle, and lower leg doctor, who can figure out what may be contributing to your IT band syndrome. They can prescribe a custom shoe insert to help with any existing problem.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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