Iliotibial Band Syndrome

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The iliotibial (IT) band is a thick band of fascia running from the pelvis down the outer thigh to the shin. IT band syndrome occurs when the band repetitively rubs against the lateral femoral condyle (outer knee) or the greater trochanteric bursa (outer hip) during the repetitive flexion-extension cycle of running or cycling. The result is lateral pain — most commonly on the outer knee, but sometimes felt more at the outer hip.

IT band syndrome is one of the most common overuse injuries in runners, accounting for up to 12% of running injuries. It is typically brought on by a rapid increase in training mileage, downhill running, or worn footwear.

Classic presentation is lateral knee or outer hip pain that starts at a predictable distance into a run and eases with rest. The Ober test assesses IT band tightness. Noble compression test — direct pressure over the lateral femoral epicondyle at 30° of flexion — reproduces the pain. Imaging is usually not required; MRI is ordered when the diagnosis is uncertain or symptoms are severe.

1. NSAIDs

   Short courses reduce acute inflammation.

2. Corticosteroid injection

   Injection at the lateral femoral epicondyle or trochanteric bursa relieves refractory cases.

Surgery is rarely necessary. When symptoms persist despite 6+ months of consistent conservative treatment, an ITB release procedure can be performed.

External patient-education references and related OSI pages for additional background:

• Britannica — Hip (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language