What Causes Iliotibial (IT) Band Syndrome? | Peak Therapy

Your IT band, or iliotibial band, is a thick band of tissue that starts at your hip, runs down the outside of your thigh, and attaches to the lateral part of the lower leg, just below the knee. IT band syndrome is an overuse injury of the connective tissues on the lateral or outer part of the thigh and knee. It causes pain and tenderness in those areas, especially above the knee joint.

What Causes IT Band Syndrome?

Inflammation of the iliotibial band occurs most often in long-distance runners, bicyclists, and athletes who repeatedly squat. It may happen because of poor muscle flexibility, poor training habits, and other mechanical imbalances in the body, especially involving the low back, pelvis, hips, and knees.

People with anatomy issues such as an abnormal tilt to the pelvis, bowed legs, or differences in the lengths of the legs may be more susceptible to develop IT band syndrome. These situations can cause the iliotibial band to become extremely tight, causing friction and irritation when the band repeatedly crosses the femoral epicondyle during activity.

Runners may develop IT Band Syndrome due to the slope of the road they run on. Roads are banked with the center of the road higher than the outside edge to allow for water runoff, so if a runner regularly runs on the same side of the road, it produces the same effect on the body as having a leg-length discrepancy. Running downhill is also stressful on the IT band as it works harder to stabilize the knee.

Bicyclists may develop IT Band Syndrome if they “toe in” when they pedal. This may come as a result of the way the toe clips are aligned, forcing the foot to rotate internally. This causes the same effect as bowed legs, increasing the angle of the IT band as it crosses the knee.

Symptoms & Signs

The most common symptom is pain on the lateral side of the knee. There may be an initial sensation of stinging or needle-like pricks, gradually progressing to pain each time the heel strikes the ground. Some may feel a popping or snapping at the knee.  

How Can Physical Therapy Help?

Foam rolling and stretching are commonly prescribed to those with IT Band Syndrome. Good physical therapy will include gait analysis, strengthening, and work on proper mechanics to improve the underlying causes.

Peak Physical Therapy

Our South Shore Physical Therapy practice specializes in physical therapy including many specialty programs including return-to-sports, vestibular, pelvic health, post-concussion, aquatics, and more. Locations include Norwell, MA, Scituate, MA, Quincy, MA, Hanover, MA, Pembroke, MA, and Braintree, MA. Our specialized programs combined with state-of-the-art facilities allow us to meet the unique needs of our local patients and achieve the fastest results. If you are unsure whether this type of treatment can help you, we offer a no-obligation FREE injury screening. Click here for more information.