Iliotibial Band
(ITB) Syndrome

What are the common symptoms of ITB syndrome

This is particularly common with middle or long distance runners, and leads to a pain on the outer side of the knee. You’ll find the pain gets worse going downhill or on longer runs. You’ll also feel tender just above the knee joint. Symptoms range from a burning or stinging feeling just above the joint to swelling where the ITB moves over the outside of the knee.

You’ll find that the pain normally comes on after you start taking part in sports, and will often increase the more you do. Pain may increase every time your heel hits the ground.

How can I manage ITB syndrome

Although many runners learn to live with ITB, the pain can become debilitating and stop you from doing any training. Your doctor will talk to you about the pain you’re experiencing and the exercise you do. They will be checking to see if you do enough stretching or warming down when you exercise, and will be interested in whether you run on surfaces that slope to the side, or on hills. If you use step exercises or ‘in-toe’ during running or cycling, that may also lead to ITB syndrome.

Your doctor will also examine your leg, looking for signs of a tight ITB and checking for things like weak hip muscles or whether you place your weight on the outside of the foot when you walk (supination). They will also check if you’re bowlegged or have one leg longer than the other.

What are the best treatments for ITB syndrome

Rest can help but will not cure the problem. In the initial onset you might try RICE (Rest, Ice, Compression, Elevation) to alleviate the pain. Physiotherapy can also be useful, and your physiotherapist may suggest stretching the ITB using a foam roller, and prescribe exercises which adjust the rotation of the leg. An IT band compression wrap can also help.

If these approaches haven’t helped, a steroid injection into the affected area might be an option. In persistent cases you may require surgery to divide the band. Once the condition is cured, it’s worth adjusting how you exercise, making sure you stretch before and afterwards, and you might find it helps to see an orthotist or podiatrist who will fit a special insole in your trainers.