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Iliotibial Band Syndrome


Iliotibial band syndrome (ITBS)

also known as runner's knee, happens when your iliotibial band becomes injured and causes pain. The iliotibial band is a long band of tissue that extends from the outside of your pelvis (hip bone) to the outside of your tibia (shin bone). It helps keeps the knee in the correct position when you stand or move. ITBS occurs most often in long distance runners and cyclists.

Iliotibial Band Syndrome

Common symptoms include the following:

  • Pain or swelling in your hip, knee, thigh, or buttock
  • Pain when you touch your hip, outer thigh, or outer part of your knee
  • Pain that gets worse during running or repetitive exercises and gets better when you rest

Contact your healthcare provider if:

  • You have a fever or chills.
  • You have redness, warmth, or severe swelling.
  • Your pain does not improve or gets worse after treatments.
  • You have questions or concerns about your condition or care.

Treatment for ITBS

may include rest and physical therapy. Surgery may be needed if other treatments do not work.


may include any of the following:

  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Medicine to decrease pain and swelling can be applied to your skin over sore areas as directed.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely.
  • Steroid injections may be given to decrease swelling.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Manage your symptoms:

  • Rest. Do not do exercises that cause pain. You may need to rest for several weeks. Ask your healthcare provider when you can resume your normal exercises.
  • Apply ice on your hip, knee or thigh for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
  • Apply heat on the area in pain for 20 to 30 minutes before your stretch or exercise. Heat helps decrease pain and makes it easier to stretch your muscles.
  • Massage painful areas as directed. Use a foam roller to gently massage your painful areas. Place the foam roller on a flat surface. Lie on your side with the foam roller against your painful leg. Move so that it rolls up and down from your hip to above your knee. Do not lie with it against the outside of your knee cap.
  • Stretch as directed. Stand and wrap your painful leg behind and to the side of your other leg. Reach your arm to the outside of the ankle of your painful leg. Hold for 15 seconds Return to the starting position. Do this 10 times. Repeat this exercise 3 to 5 times per day. Ask your healthcare provider or physical therapist for other ways to stretch.
  • Go to physical therapy as directed. Your physical therapist will teach you how to do exercises that will strengthen your hip muscles and improve your flexibility.

Prevent iliotibial band syndrome:

  • Slowly increase the time and distance that you run or bike. Start with short runs or cycle rides. Ask your healthcare provider how and when to increase your distance and time that you exercise.
  • Do not run down hills or stairs. When your healthcare provider says it is okay to exercise, run on flat surfaces only. Hills and stairs may cause pain and make your condition worse.
  • Warm up and stretch before vigorous exercise or sports.
  • Change the seat height or foot position of your bicycle. Ask your physical therapist what the correct height and foot position of your bicycle should be. Make these changes to decrease the stress on your iliotibial band.
  • Use correct body position when you exercise. Ask your healthcare provider or physical therapist how to move your legs and feet when running or cycling. This may decrease the stress on your iliotibial band.
  • Wear supportive shoes or orthotics. Orthotics are cushions that are placed inside of your shoes or sneakers. You may need orthotics in your running shoes if the bottom of your feet do not curve or arch enough off of the floor. Ask your healthcare provider if you need orthotics.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Iliotibial Band Syndrome (Ambulatory Care)

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Further information

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