Iliotibial Band Syndrome

(IT Band Friction Syndrome; ITBFS; ITBS)


Iliotibial band syndrome (ITBS) is an overuse injury. The iliotibial band (ITB) is a thick band of fibrous tissue. It runs from the hip down the outside of the thigh and attaches to the tibia. The tibia is the large bone of the lower leg.
Tendons of the Lateral Knee
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ITBS is caused by repetitive friction or rubbing of the iliotibial band against the bone on the outer side of the knee. This excessive rubbing can irritate the ITB and/or the tissue underneath.
Causes of the excessive friction include:

Risk Factors

Factors that increase your risk of getting ITBS include:


Symptoms of ITBS include:


You will be asked about your symptoms and medical history. In most cases, diagnosis can be made with a physical exam.
Your ITB function may be tested. This can be done with:
Images may be needed of your leg. This can be done with an MRI scan .


Talk with your doctor about the best treatment plan for you. Recovery time ranges depending on the grade of your injury. Treatment steps may include:

Supportive Care

The IT band will need time to heal. Supportive care may include:
  • Rest—Activities may need to be restricted. Normal activities will be gradually reintroduced as the injury heals.
  • Ice—Ice therapy may help relieve swelling. Heat therapy may be advised when normal activities are reintroduced.
  • An orthotic device may be advised to help control rotation of the foot and stabilize the knee.
Prescription or over-the-counter medications may be advised to reduce pain. Corticosteroid injections may also be advised in some cases.

Physical Therapy

A physical therapist will assess the IT band. An exercise program will be created to help recovery and to stretch and strengthen the muscles.


Surgery may be needed in cases when other treatments are not effective.


To reduce your chances of ITBS, take these steps:


American College of Sports Medicine

OrthoInfo—American Academy of Orthopaedic Surgeons


Canadian Orthopaedic Association

Department of Orthopaedics—The University of British Columbia


Baker RL, Souza RB, et al. Iliotibial band syndrome: soft tissue and biomechanical factors in evaluation and treatment. PMR. 2011;3(6):550-561.

Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35(5):451-459.

Iliotibial band (ITB) syndrome. Updated July 10, 2013. Accessed February 29, 2016.

Strauss EJ, et al. Iliotibial band syndrome: evaluation and management. J Am Acad Orthop Surg. 2011 Dec;19(12):728-36.

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