Iliotibial (IT) Band Syndrome, or Lateral Knee Pain is an overuse injury caused by friction and compression of the structures between the IT band and the outside of the knee. Training errors and biomechanical abnormalities are some of the factors that predispose to IT band syndrome.

It is commonly an issue seen in cyclists, runners, army recruits and endurance athletes. IT band syndrome accounts for 15- 24% of overuse injuries in cyclists and 1.6 – 12% in runners. Pain generally worsens the longer the person persists with the sporting activity and may be associated with local swelling and inflammation of structures between the band and the inside of the knee.

A full assessment should be carried out to rule out other causes of lateral knee pain such as lateral hamstring tendinopathy, degeneration of the lateral meniscus of the knee, osteoarthritis of the lateral compartment of the knee or referred pain from the low back.

A general misconception is that the IT band can be stretched; when in fact it is just a thickening of the fibrous tissue that surrounds the thigh like a stocking and is restricted by strong attachments to the lateral side of the knee. The TFL (tensor Fascia lata) and ¾ of the gluteus maximus muscles insert into the IT band and it is these muscle that should be targeted to reduce the tension in the IT band and therefore leads to compression of the inside of the knee.

Manual soft tissue therapy through foam rolling, stretching and trigger point release of the hip musculature are useful techniques to reduce the tension through the IT band and relieve the irritation of IT band syndrome.

Catherine Simpson

MISCP MSc. Sports Medicine