Iliotibial Band Syndrome
Iliotibial Band Syndrome (ITBS)

Description
The iliotibal (IT) band is a sheet of fascia-like connective tissue that runs from the hip, down the outside of the thigh, over the lateral (outside) of the knee joint that connects to the top of the tibia (shin bone). Normally, the band slides easily over the outside of the knee as the knee bends while walking and running. However, people with faulty foot mechanics, bowed legs, leg-length discrepancies as well as highly active individuals like runners, can experience pain where the IT band passes the knee joint. Contributing factors can include;
tight IT band, poor or worn footwear and common training errors like too much time spent running on highly cambered road surfaces.
Symptoms
  • Pain at the lateral (outside) of the knee joint experienced during and after physical activity most - commonly on a single side of the body.
  • Less common is pain higher up the IT band at or near the hip.
Pedorthic Management
  • Custom orthotics or over-the-counter insoles to maintain proper alignment of the bones in the feet, control over-pronation and improve leg alignment problems.
  • Supportive footwear that are torsionally stable (can’t be folded or twisted easily) and provide adequate shock absorption.
  • For runners, video and pressure mapping “Gait Analysis” can assist in identifying underlying gait inefficiencies that can contribute to PFPS.
Other Treatments
  • Physical therapy modalities include; icing, taping, massage, stretching programs targeting the IT band and strengthening programs targeting the hip and knee stabilizer muscle groups.
  • Training changes: modify running routes to avoid extended time spent on cambered surfaces and include level, soft surfaces like trails or grass.