What is the ITB or Iliotibial Band?

diagram of the tensor fascia lata and iliotibial band or ITB

Iliotibial Band (ITB) Syndrome

Background: The tensor fascia lata (TFL) is a long flat muscle that runs along the outside of the thigh as a continuation of the gluteus (buttocks) muscles. The Iliotibial band (ITB) is the tendon that attaches the TFL onto the side of the knee.

What does the Iliotibial Band do?

The ITB works to:

  • Help lift your thigh out to the side
  • Rotate the hip joint inwards
  • Extend and flex the knee joint at certain angles.

What Causes ITB Syndrome?

The ITB has a degree of free forward and backward motion as the knee is flexed and extended. This free motion may result in friction between the ITB and the thigh bone creating irritation, pain and inflammation.

What Contributes to ITB Problems?

  • Weak buttocks muscles
  • Over pronation of the feet (low arches)
  • Poor quality running shoes
  • Running on uneven surfaces or hills

What are the Symptoms of ITB Syndrome?

  • Pain and inflammation located on the lateral or outside portion of the knee.
  • Initially the pain may become noticeable after a few kilometers into a run and remain for the duration of the run, but subsides with rest.
  • Pain is often more noticeable running down hills.
  • Without treatment, the pain may become constant with activity and be perceptible when walking and/or going up or down stairs.

Who does ITB Syndrome affect?

Runners and cyclists are the most commonly affected athletes.

What is the Treatment for the ITB?

  • Icing to decrease inflammation. Never put ice directly on the skin, always have it wrapped in something and use the rule of 10: on for 10 minutes, off for 10 minutes, for about 1 hour.
  • Temporary decrease in physical activities
  • Soft tissue therapies such as myofascial release therapy to break up scar tissue and fibrous adhesions (talk to your chiropractor)
  • Once out of the initial stage of injury gentle side stretches are beneficial
  • Strengthening exercises for the abductors of the hip joint ie the gluteal muscles
  • Orthotics if the injury is a result of poor foot mechanics (ask your chiropractor)

By Dr. Kim Macanuel, BSc, DC.