Iliotibial Band Syndrome

Clinical Notes : Orthopedics and Trauma

Iliotibial Band (ITB) Syndrome

Overuse injury causing pain on the outside part of the knee especially during running when the heel strikes the ground.

Iliotibial Band Syndrome (ITBS) affects primarily the outside of the knee (the lateral or outward-facing side of the knee).

Don’t confuse it with Patellofemoral Pain Syndrome (PFPS) which affects the kneecap and surrounding area. This picture is of a right knee.

Etiology

Overuse injury leading to repetitive friction of the ITB sliding over the lateral femoral epicondyle
Predisposing factors include
- excessive training load
- over-training
- downhill/distance running
Other factors that predispose an athlete to ITBS include
- excessive internal tibial rotation
- genu varum
- increased pronation of the foot.

Presentation

Incidence

Commonest cause of lateral knee pain in runners.
Cyclists are at risk for ITB syndrome if they tend to pedal with their toes turned in (internally rotated), which can cause abnormal stretching of the iliotibial band at the knee.
Increased frequency in adolescents undergoing the rapid growth phase.

Diagnosis is clinical

Management

Acute phase - RICE
- Rest
- Ice
- Compression
- Elevation
Medication
- NSAIDS
Sub-acute phase
- ITB stretching
Chronic condition - refer for consideration
- Ultrasound
- Steroid injection
- Surgery to lengthen the ITB