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IT Band Syndrome – Treatment Basics

By David Grauer, MD
Sports Medicine | Orthopedics

Iliotibial (IT) Band and Knee Pain

One of the most common overuse injuries for runners, triathletes, and cyclists

Now that the weather is warmer and the days are longer, many of us are increasing our running and cycling activities. Iliotibial (IT) Band Syndrome is a common injury that can interfere with training. The IT Band is a thick band of tissue on the outside of the leg that runs from the pelvis to the tibia (shin bone), just below the knee. This structure can become tight and inflamed, causing it to rub and create friction over the wide flare of the lower femur (thigh bone) with repetitive bending and straightening of the knee.

Symptoms are activity-related pain on the outside aspect of the knee which can be quite
severe. The pain is usually improved with rest, can sometimes radiate up the thigh, and
is not usually associated with swelling.

Initial treatment is to decrease mileage and/ or intensity during exercise, apply ice, take anti-inflammatory medications, and physical therapy (PT). Specific PT exercises are usually quite successful and include:

  • Stretching the muscular attachments to the IT Band, including the tensor
    fascia lata (hip flexor), gluteus maximus (hip extensor), and vastus lateralis
    (quadriceps);
  • Strengthening the hip external rotators and abductors;
  • Manual therapy, dry needling, joint mobilization, and foam rolling.

If physical therapy does not relieve symptoms, one or two cortisone injections are safe for many patients and can be quite helpful. In the event that IT Band Syndrome becomes chronic and recalcitrant to the above treatments, a surgical procedure to lengthen the IT Band can be considered, which is followed by post-operative PT. This is a minor outpatient procedure with a high success rate.

Good luck with your training, and stay safe!
~ David Grauer, MD

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About David Grauer, MD
Sports Medicine and Orthopedics

As a board certified sports medicine physician and orthopedic surgeon, Dr. Grauer enjoys helping his patients, who are often athletes of all levels, return to their sports and activities as quickly and safely as possible.

In his free time, Dr. Grauer loves spending time with his family and enjoys all the outdoor activities that the Rocky Mountains have to offer, including mountain bike racing and skiing.

Dr. Grauer welcomes patients to his orthopedic clinics in Boulder and Louisville, Colorado.

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