Iliotibial band friction syndrome (ITBFS)

What is it?

The iliotibial band is a band of strong connective tissue which runs from the pelvic bone (ilium) down the outside of the thigh to the top of the shin bone (tibia). Iliotibial band friction syndrome is a condition which describes the rubbing of this band of tissue as it passes over a bony bump on the outside of the knee joint.

How does it happen?

Iliotibial band friction syndrome is an overuse injury. When the knee is bent and straightened, the iliotibial band slides over a bony bump on the outside of the knee. When this is performed repeatedly or when the band is excessively tight, wear and tear of the band can develop as it flicks over the bony bump. To heal this damage, the body commences an inflammatory response. This can cause pain at the site of the injury.

How does it feel?

Iliotibial band friction syndrome results in pain felt on the outside of the knee. This pain is often aggravated by activities which involve repeated bending and straightening of the knee, such as running. It typically develops gradually. Initially, the pain may begin as a dull ache down the side of the knee which appears near the end of the session and disappears when you stop. However, if you continue to exercise and cause further rubbing of the iliotibial band, the pain may progress to become more intense and appear earlier in a session. It may also take longer to disappear when you stop exercising.

What should you do?

Iliotibial band friction syndrome generally does not get better on its own if the cause is not addressed and you continue to exercise. If you have, or suspect you have Iliotibial band friction syndrome, you should consult an experienced sports physiotherapist. In the meantime, you can begin initial treatment. This should consist of icing following exercise. Icing should consist of crushed ice wrapped in a moist towel applied for 15-20 minutes over the outside of the knee or ice in a paper cup massaged up and down the outside of the knee until the skin is numb every 1-2 hours.

What shouldn’t you do?

If you have or suspect you have Iliotibial band friction syndrome, you shouldn’t ignore the problem. This may lead to your problem getting worse such that your pain becomes more severe and is felt more frequently.

Could there be any long-term effects?

Iliotibial band friction syndrome generally does not produce any long-term effects, as long as it is properly diagnosed and appropriately treated. Recovery usually takes a number of weeks. During this period you can often keep exercising, depending on the severity of your pain. In a small number of cases, recovery may be prolonged.

Management

The assistance of an experienced sports physiotherapist is important in the treatment of iliotibial band friction syndrome. Initially, they can assist in diagnosing the problem and establish its severity. From this, the sports physio will be able to determine an appropriate treatment plan. This may involve initial activity modification, the taking of anti-inflammatory medications, soft tissue treatment such as massage and stretching, and specific strengthening exercises to stop rubbing of the iliotibial band. A Sports & Exercise Physio will also be able to assess and determine why you developed Iliotibial band friction syndrome and address this during your recovery to prevent a re-occurrence when you return to exercise and sport.

Tom is a physio in Balgowlah who is highly trained in the assessment and management of all knee conditions. For a complete understanding of your knee, you will need an assessment face-to-face. To see the most highly regarded physio in Balgowlah, book here.

Brukner & Khan (2012) Clinical Sports Medicine.