What is iliotibial band syndrome (ITBS)?

What is iliotibial band syndrome (ITBS)?

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Iliotibial Band Syndrome (ITBS), also known as IT band friction syndrome, is a common overuse injury that affects the iliotibial band—a thick band of fibrous tissue that runs along the outside of the thigh from the hip to just below the knee. The iliotibial band (IT band) plays a crucial role in stabilizing the knee joint during movement.

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ITBS occurs when the iliotibial band becomes irritated or inflamed as it rubs against the bony prominence on the outer side of the knee joint (lateral epicondyle) during repetitive movements. This friction and repetitive stress can lead to pain and discomfort in the outer part of the knee and thigh.

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Common symptoms of iliotibial band syndrome

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The most common symptom of ITBS is sharp, aching type of pain and tenderness on the outside of the knee, which can sometimes radiate up the thigh or down the leg. The pain is often aggravated during activities that involve repetitive knee bending and straightening, such as running downhill or climbing stairs. It may subside with rest but return when the activity is resumed.

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What causes iliotibial band syndrome?

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ITBS is typically caused by repetitive activities that involve bending and straightening the knee, such as running, cycling, hiking, or repetitive use of the leg in certain sports. Factors that can contribute to the development of ITBS include:

1. Overtraining or Sudden Increase in Activity: Rapidly increasing the intensity, duration, or frequency of exercises can overload the IT band
2. Muscle Imbalances: Weakness or imbalances in the hip, thigh, and core muscles can affect the alignment and function of the knee and lead to increased stress on the IT band.
3. Poor Biomechanics: Biomechanical alterations  such as overpronation (inward rolling of the foot), internal tibial torsion (inward twisting of the shin bone), and genu varum (bow legs) can increase the risk of ITBS.
4. Tightness in Muscles: Tight hip muscles, such as tensor fasciae latae (muscle of the thigh that is attached to the outer side of the knee) or gluteus maximus (outer muscle of the buttock) is a contributing factor in developing ITBS.  

How can physical therapy help? 

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Physical therapy can be highly effective in the management and treatment of iliotibial band syndrome (ITBS). A physical therapist can provide targeted interventions to reduce pain, address underlying factors contributing to ITBS, improve muscle imbalances, and promote a safe return to activity. Here's how physical therapy can help with ITBS:

1. Pain Management: Physical therapists may use various modalities such as heat, ice, or ultrasound and electrical stimulation to help reduce pain and inflammation in the affected area.
2. Rest and Activity Modification: Physical therapists will advise on appropriate rest periods and activity modification to avoid activities that aggravate ITBS and allow the inflamed tissues to heal.
3. Stretching Exercises: Gentle stretching exercises such as manual and self-stretching techniques are prescribed to improve the flexibility of the IT band, hip, and thigh muscles. These stretches can help reduce tension on the IT band, increase range of motion and alleviate pain.
4. Strengthening Exercises: Physical therapists design a customized strengthening program to target the hip, thigh, and core muscles. Strengthening these muscles can help correct imbalances, improve muscular endurance of the lower limb, provide better dynamic knee stability, and reduce stress on the IT band.
5. Foam Rolling or Self-Myofascial Release: Self-myofascial release with the use of a foam roller on the tight muscles is beneficial. It can help release tension in the IT band and surrounding muscles.
6. Biomechanical Assessment and Modification: Physical therapists can assess lower extremity mechanics, and modify any faulty alignment that may be contributing to ITBS. For example, if the patient exhibits excessive foot pronation (inward rolling of the foot), a foot orthosis may be prescribed to reduce the stress on the knee and decrease pain. 
7. Gait Analysis: Analyzing the patient's walking or running patterns can help identify any abnormal movement patterns that may be contributing to ITBS.
8. Balance and Proprioception Training: A progression of balance and proprioception exercises that requires the trunk and lower extremity control are essential components of the program to help improve joint awareness and stability, which can be crucial for preventing re-injury and promoting proper movement patterns.
9. Simulated Work-Related Activities and Sport-Specific Drills: A final component  of an individualized rehabilitation program involves practicing activities that simulate the physical demands of a patient’s work or sport activity. Simulated activities and drills enable patients to practice under supervised conditions to receive feedback on correct mechanics. 
10. Home Exercise Program: To facilitate ongoing progress, physical therapists often provide patients with a home exercise program to reinforce the intervention and continue their exercises and self-management between therapy sessions.
11. Education: Physical therapists educate patients about the ITBS, its causes and symptoms. They also teach the importance of  proper body mechanics, wearing appropriate footwear, and techniques to prevent re-injury and improve overall lower limb health.

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It's essential to remember that the treatment plan for ITBS will be tailored to the individual's specific needs, the severity of the condition, and their overall health status. Consistency and compliance with the prescribed exercises and therapies are key to achieving positive outcomes with physical therapy for ITBS. If you experience persistent or severe ITBS symptoms, consult a healthcare professional for an accurate diagnosis and appropriate treatment plan.

Trust PeteHealth for treating iliotibial band syndrome

Looking for a physical therapist to help you manage and treat iliotibial band syndrome? PeteHealth is the trusted physical therapy solution that you can access on your schedule, bringing you the care you need wherever you need it – including your home or office. Our licensed physical therapists are at the top of their profession, and we accept most insurance carriers.

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Finally – the all-in-one, professional, convenient approach to physical therapy that you deserve with PeteHealth.

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