If you haveiliotibial band friction syndrome(ITBFS), you may benefit from the skilled treatments of a physical therapist to help relieve your pain and improve your mobility. ITBFS is a condition that occurs when abnormal rubbing or friction occurs at the side of the knee where the iliotibial band (IT band) crosses.

The abnormal rubbing causes the IT band to become inflamed and can cause knee pain.Occasionally the pain can be felt up and down the outside of the affected thigh and may even be felt as hip pain.

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A man holding his knee in pain

The Role of the Iliotibial Band

The IT band is a thick band of tissue that runs on the outer part of the thigh between the hip and the knee. As it crosses the knee it passes over the lateral epicondyle of the femur (thigh bone), it attaches to the front of the shin bone, or tibia. There is a bursa beneath the IT band that helps the band glide smoothly when you bend and straighten your knee.

Symptoms of ITBFS

Common symptoms of ITBFS are burning pain in the outside part of the knee or pain over the outer part of the thigh or hip. The burning pain typically occurs during exercises that require repetitive bending and straightening like cycling or running.

Causes

There are many causes of ITBFS. Occasionally, tight muscles around the hip and the knee can cause abnormal friction between the IT band and the bones of the hip or knee.The IT band may be subjected to rubbing forces as it passes over bony prominences near the knee.

Physical Therapy Evaluation

If you are experiencing pain in the outer part of the hip or knee, you may have ITBFS. Sometimes the symptoms of ITBFS are short-lived and can go away with rest. If your pain is persistent or interferes with normal activity, you should see your healthcare provider to help you initiate the proper treatment. A physical therapy evaluation may be necessary to help discover the causes of the problem and lead to proper management.​

Thephysical therapy evaluation for ITBFSusually starts with a focused history. Be prepared to tell your physical therapist when your symptoms started and how specific activities affect your symptoms. The history helps your physical therapist choose where to focus the evaluation. Tests and measures may include:

Once your PT has performed an evaluation, he or she will work with you to develop a treatment program specifically for your condition. Here are the phases of treatment.

Acute Phase

The first three to five days of pain in the knee or hip are considered the acute phase of injury to the IT band. During this time, avoidance of the activity that caused the pain is recommended. Ice to the affected area can help control the inflammation. Ice should be applied for 15 to 20 minutes several times per day during the acute phase.

Subacute Phase

Return to Activity

After a few weeks of gentle strengthening and stretching, more aggressive exercises can be performed to ensure that the IT band is able to tolerate the forces that it may encounter during your athletic activity.

Advanced hip-strengthening exercises can be started to ensure that the hip and abdominal muscles are providing proper support. If foot pronation is a problem, orthotics or inserts may be tried in the shoes to correct the problem.

ITBFS usually lasts about six to eight weeks, depending on the severity of the injury.If your symptoms are persistent, a follow-up visit with your healthcare provider may be necessary to see if more invasive treatment options, likecortisone injections, are warranted.

4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hadeed A, Tapscott DC.Iliotibial Band Friction Syndrome. In:StatPearls. Treasure Island, FL: StatPearls Publishing; 2019.Saikia S, Tepe R.Etiology, Treatment, and Prevention of ITB Syndrome: A Literature Review.Topics in Integrative Health Care. 2013;4(3).Lavine R.Iliotibial band friction syndrome.Curr Rev Musculoskelet Med. 2010;3(1-4):18-22. doi:10.1007/s12178-010-9061-8Beals C, Flanigan D.A Review of Treatments for Iliotibial Band Syndrome in the Athletic Population.J Sports Med. 2013;2013:367169. doi:10.1155/2013/367169Additional ReadingHertling D, Kessler RM.Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. 4th ed. Lippincott Williams & Wilkins; 2005.

4 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hadeed A, Tapscott DC.Iliotibial Band Friction Syndrome. In:StatPearls. Treasure Island, FL: StatPearls Publishing; 2019.Saikia S, Tepe R.Etiology, Treatment, and Prevention of ITB Syndrome: A Literature Review.Topics in Integrative Health Care. 2013;4(3).Lavine R.Iliotibial band friction syndrome.Curr Rev Musculoskelet Med. 2010;3(1-4):18-22. doi:10.1007/s12178-010-9061-8Beals C, Flanigan D.A Review of Treatments for Iliotibial Band Syndrome in the Athletic Population.J Sports Med. 2013;2013:367169. doi:10.1155/2013/367169Additional ReadingHertling D, Kessler RM.Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. 4th ed. Lippincott Williams & Wilkins; 2005.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Hadeed A, Tapscott DC.Iliotibial Band Friction Syndrome. In:StatPearls. Treasure Island, FL: StatPearls Publishing; 2019.Saikia S, Tepe R.Etiology, Treatment, and Prevention of ITB Syndrome: A Literature Review.Topics in Integrative Health Care. 2013;4(3).Lavine R.Iliotibial band friction syndrome.Curr Rev Musculoskelet Med. 2010;3(1-4):18-22. doi:10.1007/s12178-010-9061-8Beals C, Flanigan D.A Review of Treatments for Iliotibial Band Syndrome in the Athletic Population.J Sports Med. 2013;2013:367169. doi:10.1155/2013/367169

Hadeed A, Tapscott DC.Iliotibial Band Friction Syndrome. In:StatPearls. Treasure Island, FL: StatPearls Publishing; 2019.

Saikia S, Tepe R.Etiology, Treatment, and Prevention of ITB Syndrome: A Literature Review.Topics in Integrative Health Care. 2013;4(3).

Lavine R.Iliotibial band friction syndrome.Curr Rev Musculoskelet Med. 2010;3(1-4):18-22. doi:10.1007/s12178-010-9061-8

Beals C, Flanigan D.A Review of Treatments for Iliotibial Band Syndrome in the Athletic Population.J Sports Med. 2013;2013:367169. doi:10.1155/2013/367169

Hertling D, Kessler RM.Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. 4th ed. Lippincott Williams & Wilkins; 2005.

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