University of Virginia Health System

Iliotibial band friction syndrome is an overuse injury found especially in long-distance runners. The iliotibial (IT) band is a ligament tract that runs along the outside of the thigh from the buttock muscle (gluteus maximus) to the knee. When the IT band rubs against the large leg bone, called the femur, friction can occur causing inflammation and pain on the outside of the knee.

Signs and Symptoms:
The runner will notice a dull ache about the side of the knee after a mile or two into the run. The ache usually disappears soon after the run is over. In severe cases, the pain can be sharp and the outside of the knee will be tender or swollen.

Causes:
Any activity that causes the leg to bend inward - stretching the IT band against the femur - can cause this syndrome. Wearing worn-out running shoes or conducting workouts on downhill or indoor banked surfaces can contribute to this condition. Having a tight IT band or stepping up your training quickly can cause this injury too.

Treatment:
These injuries produce few long-term problems when they are treated early and appropriately. Usually a runner can't run through the IT band pain. The athlete needs to cut back on speed, eliminate downhill activity, and properly stretch the IT band several times a day to restore the band's flexibility.

Stretching the IT band is the most common and effective treatment. Stand with your right leg crossed in the back of your left leg. Extend your left arm out to the side, against a wall or chair. Lean your weight against the wall or chair while pushing your right hip in the opposite direction. Keep your right foot anchored to the floor while allowing your left knee to bend or flex. You should feel a stretch in the IT band in your right hip that extends down the outside of your right leg. Switch to the opposite leg and repeat this stretch so you can keep both IT bands flexible. You can get additional relief by icing the painful knee for 15 to 20 minutes after exercising. Aspirin or ibuprofen will help to decrease the pain and the swelling.

You should be back to easy running within two to four weeks. If your IT band syndrome isn't responding to your treatment after a month, see an orthopaedic surgeon. Severe or chronic cases may require having the surgeon inject cortisone under the band to alleviate the pain. Surgical treatment is rarely necessary.

Remember to always stretch the IT bands after a workout. Warm up well before a run. Strengthen your quadriceps and hamstrings too. If you follow these simple measures, you can prevent this syndrome from occurring in the first place.