Symptoms

ITBS symptoms range from a stinging sensation just above the knee joint (on the outside of the knee or along the entire length of the iliotibial band) to swelling or thickening of the tissue at the point where the band moves over the femur. The pain may not occur immediately during activity, but may intensify over time, especially as the foot strikes the ground. Pain might persist after activity. Pain may also be present below the knee, where the ITB actually attaches to the tibia.

ITBS can also occur where the IT band connects to the hip, though this is less likely as a sports injury. It commonly occurs during pregnancy, as the connective tissues loosen and the woman gains weight -- each process adding more pressure. ITBS at the hip also commonly affects the elderly. ITBS at the hip is studied less; few treatments are generally known.

Sports activities to avoid while symptomatic

• Running
• Stair climbing
• Deadlifts or squats
• Court sports, such as tennis, basketball, or similar
• Martial arts, such as karate (especially where being bare foot emphasises any symptoms being caused by leg/foot abnormalities)
• Bowling
• Wrestling
• Cycling

Causes

ITBS can result from one or more of the following training habits, anatomical abnormalities, or muscular imbalances:

Training habits:

• Always Running on a banked surface (such as the shoulder of a road or an indoor track) bends the downhill leg slightly inward and causes extreme stretching of the band against the femur
• Inadequate warm-up or cool-down
• Excessive up-hill and down-hill running
• In cycling, having the feet "toed-in" to an excessive angle
• Running up and down stairs
• Hiking long distances
• Rowing Abnormalities in leg/feet anatomy:
• High or low arches
• Over-pronation of the foot
• The force at the knee when the foot strikes
• Uneven leg length
• Bowlegs or tightness about the iliotibial band.
• Excessive wear on the outside heel edge of a running shoe (compared to the inside) is one common indicator of bowleggedness for runners. Muscle imbalance:
• Weak hip abductor muscles
• Weak/non-firing multifidi muscles

Treatment

Treatment of ITBS begins with proper footwear, icing the area of pain, and a stretching routine. Limiting excessive training, resting for a period of time, and incorporating low-impact cross-training activities may also help. Anti-inflammatory medications may be prescribed by your doctor to help decrease the inflammatory response around the area of irritation. If these treatments do not solve the problem, working with a physical therapist to develop a more focused stretching and strengthening routine may help. Cortisone injection into the area of inflammation may also be attempted, usually after these other treatments fail. If all else fails, surgery is an option, but only in very rare circumstances.