Dr. William R. Beach, Tuckahoe Orthopaedics.By William R. Beach, MD
The iliotibial band (IT band) is a band of tough, fibrous connective tissue. The IT band runs down the outside of the thigh, from the illium (hip) to the tibia (inside bone of your lower leg). The IT band works with your quadriceps (thigh muscles) to provide stability to the outside of the knee joint during repetitive movement such as running, biking, rowing, marching (think band camp or military drilling), or the use of elliptical machines.

What is IT Band Syndrome?

IT Band Syndrome, or ITBS, is a painful overuse injury that affects your IT band causing it to be incredibly painful, tender or sore. It’s also the most common cause of lateral knee pain in runners. ITBS pain typically comes on gradually, but it can be incredibly painful. ITBS pain can radiate up and down the leg and into the shin, but at the onset it tends to present simply as tenderness at one or more points along the ligament.

If not treated, it can easily progress to a more intense and extensive pain, potentially limiting your activity levels. The only real risk to the ITBS sufferer is increased pain.

Symptoms and Common Causes of ITBS

Whether you’re an athlete or a weekend warrior, the one common factor that researchers have identified as the source of ITBS is weak hip and quad muscles. So, although ITBS is much more common in athletes, you don’t have to be an athlete to suffer from this lateral knee pain. Any activity that involves repetitive flexing and extension of your knee, like marching, working out on an elliptical machine at the gym, rowing machines, cycling, stair climbing, or even some job tasks can lead to ITBS. People who run on inside running tracks, run downhill or on uneven ground, or through poor posture or injury may also develop ITBS.

Most sufferers experience these general symptoms:

  • Point tenderness along the band
  • Significant discomfort in the IT band or the leg itself
  • Pain that radiates both up the leg and down into the shin
  • Pain that becomes worse with activity
  • Pain that becomes better with rest and/or icing
  • Gradual onset of pain or discomfort

The pain may also be caused by inadequate stretching, little or no warm-up, wrong set-up, or having your toe too internally rotated.

Differentiating ITBS with Lateral Meniscus Tear

The threat or fear of a Lateral Meniscus Tear can be frightening for anyone, but more so for an athlete. Many athletes may jump to the conclusion they’ve experienced a tear if the pain is severe, radiates up and down the leg, and becomes worse with activity. However, there are ways to differentiate these two problems.

Indication of a Lateral Meniscus Tear:

  • Pain is on the joint line, joint base, and usually causes fluid and pain.
  • Presents with mechanical symptoms, such as a click or pop.
  • In younger people, a lateral meniscus tear is often due to a traumatic injury, and the knee or joint often swells, prompting that clicking sound or feeling.

Indication of Iliotibial Band Syndrome:

  • IT Band pain is often located just slightly above where a lateral meniscus tear is felt.
  • ITBS is more chronic or ongoing, and is not often related to one traumatic event.
  • You rarely experience swelling, but may develop a bursa (a small bag or pouch of fluid that develops under the IT band), creating more discomfort.

Knees are complex joints. There are a variety of things that can cause knee pain—some more and some less serious than ITBS.

If you’re concerned with pain in your IT band, or any pain in your knee joint, please contact us today to schedule an appointment at Tuckahoe Orthopaedics.

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