HealthSheets™

Adhering to the principles of health literacy, this extensive library of evidence-based, peer-reviewed information was written specifically for patients and covers diseases and conditions, diagnosis and treatments, surgeries and procedures, and wellness and safety for people of all ages and walks of life.

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Iliotibial Band Syndrome

The iliotibial band is a layer of connective tissue that runs along the outside of the thigh. The band connects a muscle near your hip to the larger bone in your shin (tibia). When it becomes inflamed, it causes pain on the outer side of your knee. This is called iliotibial band syndrome (ITBS).

What causes it?

Sometimes the band rubs over the bump of the thigh bone (femur) near your knee. When this happens often, it irritates the band. This happens most often while running. Some of the common causes are:

Having a tight iliotibial band.
Having tight muscles in your hip, pelvis or leg.
Having legs that are not the same length.
Running on sloped surfaces.
Running in shoes with a lot of wear on the outside of the heel.

What are the symptoms?

The main symptom of this condition is pain on the outer side of your knee. Some people feel a stinging or needle-like prickling first. The pain tends to grow worse over time. Eventually, you may feel pain every time your heel hits the ground.

Some people notice a snapping or popping sound at their knee. There may also be some swelling.

Your health care provider can diagnose ITBS by examining your knee. He or she will need to move it in different ways.

How is it treated?

Your health care provider may give you special exercises to help your knee recover. He or she may also give you a corticosteroid shot to help with the inflammation. While your knee is healing, you may also:

Ice the area every 3 to 4 hours. Use an ice pack, gel pack, or a package of frozen vegetables. Be sure to wrap your cold pack in a cloth first. Leave it in place for up to 20 minutes at a time.
Give yourself an ice massage. Freeze water in a Styrofoam cup, then peel the top of the cup away to uncover the ice. Hold the bottom of the cup and rub the ice over your iliotibial band. Do this for 5 to 10 minutes, several times a day.
Take an anti-inflammatory medicine such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Ask your doctor how much to take. Nonsteroidal anti-inflammatory medicines (NSAIDs) can cause stomach bleeding and other problems. These risks increase with age, taking larger doses, or taking them for a longer period of time. Always read the label carefully and follow the directions. Don’t take them for more than 10 days unless your doctor says you should.

While your knee heals, you will need to stop doing the activity that caused your pain. Switch to a different activity that doesn’t make your condition worse. For example, you might try bicycling instead of running. Talk to your doctor about other activities you could try.

How long will the effects last?

Everyone’s body heals at its own pace. Your age, general health, and any past injuries all affect the time you need for recovery. A mild injury may heal in just a few weeks. A severe injury may take 6 weeks or longer to recover.

Whether your injury is mild or severe, stop doing the activity that caused your pain. If you keep doing the same activities, you’ll irritate your iliotibial band more. This will bring back your symptoms and slow your recovery. You can try the activity again after you fully heal.

When can I go back to my normal activities?

Recovery time is different for everyone. When you can resume your normal activities isn’t a matter of how many days or weeks have passed since your injury occurred. Instead, it depends on when your knee recovers. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. It is important to be patient. If you return too soon, you can make your injury worse. This will make your recovery take longer.

Use the following checklist as a guide. Wait until all of these are true, starting from the top and working through to the end. You can safely return to your activities when:

You can completely straighten and bend your knee without pain.
Your injured knee and leg are back to normal strength compared with the uninjured knee and leg.
You can walk or jog straight ahead without limping.

How can I prevent ITBS?

Always make sure to warm up properly before sports or other activities. Stretching after activities is a good idea as well. These will help prevent future injuries. Talk to your health care provider about what warm-ups and stretches are best for you.