Iliotibial (IT) Band Syndrome

The iliotibial band (IT band) is a tendon that runs down the length of the outer thigh, from the top of the pelvis to the shin bone. Iliotibial (IT) band syndrome is an overuse injury of this tendon.

Download our overview and stretches PDF

Causes

There are a number of reasons why Iliotibial (IT) band syndrome may occur. Some common ones include:

  • Improper stretching program before and after workouts

  • Over training or repetitively bending the knee (such as in biking or running)

  • Improper sports training

  • Abnormality in the leg, such as one is longer than the other

Symptoms

Common symptoms related to IT band syndrome are:

  • Pain at the front or outside of the knee

  • Pain at the hip or outside of the knee or lower thigh which worsens going down stairs

  • Increased pain with repeated use

  • Popping at the lateral hip or knee

Diagnosis

To determine if your child has IT band syndrome, our specialists will perform a physical exam that may include flexibility tests, stress tests, muscle tests and gait analysis. These additional tests will help our specialized team better understand your child’s condition, assess range of motion and identify abnormalities that might occur in bone alignment or muscle function.

After a physical exam, our specialists may also order imaging tests such as an X-ray. In some rare cases, advanced imaging is warranted.

Treatment

Possible non-surgical treatments your doctor may offer or recommend to treat your child’s IT band syndrome include:

  • Physical therapy

  • Home exercise program

  • Over the counter nonsteroidal anti-inflammatory drug (NSAIDs)

  • Activity modification

  • In rare cases, steroid injections

At-Home Care

Common at-home treatment options for IT band syndrome include:

  • Icing the Area:

    Put ice packs wrapped in a towel or thin cloth on your child’s affected area for 20–30 minutes every 3-4 hours for the first 2-3 days. If pain does not go away, contact your healthcare provider.

  • Elevating the Injured Limb:

    If your child has a broken leg, elevate it by placing it on a pillow when your child is lying down. Elevating it above the heart level can help reduce swelling and pain.

  • Taking Non-Prescription Medication:

    Take a non-steroidal, anti-inflammatory drug (NSAID), such as ibuprofen as recommended by your healthcare provider.

  • Exercising:

    Your doctor may recommend doing exercises at home. These are designed to stretch the affected joint, maintain range of motion in the joint and strengthen your child’s joint.

Rehabilitation Exercises

Below are common exercises a doctor may recommend to help your child recover from IT band syndrome. Always check with your doctor to find out which exercises are right for your child.

Iliotibial Band Stretch (Standing)

  • Cross uninjured leg over injured leg.

  • Bend down to touch toes.

  • Hold for 30 seconds, then come back up to the starting position.

  • Repeat 3 times.

Iliotibial Band Stretch (Side Leaning)

  • Stand sideways to a wall, move injured leg toward the inside.

  • Place the hand nearest the wall on the wall for support.

  • Cross uninjured leg over the injured leg, keeping the foot of the injured leg stable.

  • Lean into the wall.

  • Hold the stretch for 10 seconds. Do 2 sets of 10.

Standing Calf Stretch

  • Facing a wall, put hands against the wall at about eye level.

  • Keep the uninjured leg forward and the injured leg back about 12-18 inches.

  • Keep the injured leg straight and the heel on the floor.

  • Keep toes pointed towards the wall.

  • Next, do a slight lunge by bending the knee of the forward leg. Tell your child to lean into the wall until they feel a stretch in the calf muscle.

  • Hold for 30-60 seconds. Repeat 3 times.

Hamstring Stretch

  • Lie on back and bring the affected leg towards the chest.

  • Grab the back of the thigh and try to extend the leg.

  • Your child may also try this with a towel around the foot if it is more comfortable.

  • Hold for 30-60 seconds. Repeat 3 times.

Standing Calf Stretch

  • Facing a wall, put hands against the wall at about eye level.

  • Keep the uninjured leg forward and the injured leg back about 12-18 inches.

  • Keep the injured leg straight and the heel on the floor.

  • Keep toes pointed towards the wall.

  • Next, do a slight lunge by bending the knee of the forward leg. Tell your child to lean into the wall until they feel a stretch in the calf muscle.

  • Hold for 30-60 seconds. Repeat 3 times.

Strengthening

Vastus Medialis Oblique Quadriceps Sets

  • Sit on the floor with injured leg straight in front.

  • Press the back of the knee down while tightening the muscles on the top of the thigh.

  • Concentrate on tightening muscles on the inner side of kneecap.

  • Hold for 5 seconds. Complete 3 sets of 10.

Straight Leg Raise

  • Sit on the floor with the injured leg straight and the other leg bent, foot on the floor.

  • Pull the toes of the injured leg in as far as possible, while pressing the back of the knee down and tightening the muscles on the top of the thigh.

  • Raise the leg six to eight inches off the floor and hold for 5 seconds.

  • Slowly lower back to the floor.

  • Complete 3 sets of 10.

Hip Adduction (Side Lying)

  • Lie on injured side with top leg bent and flat foot placed in front of the injured leg, which is kept straight.

  • Raise injured leg as far as possible and hold for 5 seconds.

  • Keep hips still while lifting leg.

  • Hold for 5 seconds, then slowly lower leg. Repeat 20 times.

Wall Squat with Ball

  • Stand with back, shoulders, and head against a wall and look straight ahead.

  • Keep shoulders relaxed and feet one foot away from the wall, shoulder width apart.

  • Place a rolled-up pillow or a Nerf ball between thighs.

  • Keep head against the wall, and slowly squat while squeezing the pillow or ball at the same time.

  • Squat until thighs are parallel to the floor.

  • Hold for 10 seconds. Slowly stand back up. Repeat 20 times.

Hip Adduction with Latex Stretch Band

  • Stand sideways with injured leg toward a door.

  • Loop the tubing around the ankle of injured leg.

  • Anchor the other end of tubing by tying a knot in it, slipping it between the door and the frame about 8–10 inches above the floor, and closing the door.

  • Keep injured knee straight, then bring it across the body.

  • Return to the starting position. Repeat 20 times.

When Will My Child Return to Play?

After your child has developed IT band syndrome, it’s normal to want to know how long the injury will take to heal and what you can expect. Every child is unique, every injury is different, and your doctor will be able to give you general guidelines as to when your child may be able to return to play.

How to Prevent IT Band Syndrome

  • Proper pre- and post-workout stretching program

  • Avoid running in the same direction on an indoor track or on the same side of a banked road

  • Don’t let toes turn inward when pedaling a bike

  • Avoid sports or activities that make the problem worse

See more information

Orthopedic Rehabilitation

Sports Medicine