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Iliotibial band syndrome - aftercare

IT band syndrome - aftercare; ITB syndrome - aftercare; Iliotibial band friction syndrome - aftercare

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Description

The iliotibial band (ITB) is a tendon that runs along the outside of your leg. It connects from the top of your pelvic bone to just below your knee. A tendon is thick elastic tissue that connects muscle to bone.

Iliotibial band syndrome occurs when the ITB becomes swollen and irritated from rubbing against the bone on the outside of your hip or knee.

More About Your Injury

There is a fluid-filled sac, called a bursa, between the bone and the tendon on the outside part of your leg. The sac provides lubrication between the tendon and the bone. The rubbing of the tendon can cause pain and swelling of the bursa, the tendon, or both.

This injury often affects runners and cyclists. Bending the knee over and over during these activities can create irritation and swelling of the tendon.

Other causes include:

What to Expect

If you have ITB syndrome you may notice:

Your doctor will examine your knee and move your leg in different positions to see if your ITB is tight. Usually, ITB syndrome can be diagnosed from the exam and your description of the symptoms.

If imaging tests are needed, they may include any of the following:

If you have ITB syndrome, treatment may involve any of the following:

Most people do not need surgery. But if other treatments do not work, surgery may be recommended. During surgery, part of your ITB, the bursa, or both will be removed. Or, the ITB will be lengthened. This prevents the ITB from rubbing against the bone at the side of your knee.

Symptom Relief

At home, follow these measures to help reduce pain and swelling:

For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store.

Activity

Try running or cycling shorter distances than you usually do. If you still have pain, avoid these activities completely. You may need to do other exercises that do not irritate your ITB, such as swimming.

Try wearing a knee sleeve to keep the bursa and ITB warm while you exercise.

Your doctor may recommend a physical therapist (PT) to work with your specific injury so you can return to normal activity as soon as possible.

Your PT may recommend ways to change how you exercise to prevent problems. Exercises are aimed at strengthening your core and hip muscles. It will also focus on stretching your tissue to allow less irritation. You may also be fitted for arch supports (orthotics) to wear in your shoes.

Once you can do stretching and strengthening exercises without pain, you can gradually begin running or cycling again. Slowly build up distance and speed.

Self-care at Home

Your PT may give you exercises to do to help stretch your ITB and strengthen your leg muscles. Before and after activity:

The best way for the tendons to heal is to stick to a care plan. The more you rest and practice physical therapy, the quicker and better your injury will heal.

When to Call the Doctor

Call your health care provider if pain gets worse or does not get better in a few weeks.

References

Akuthota V, Stilp SK, Lento P, Gonzalez P, Putnam AR. Iliotibial band syndrome. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 69.

Huntoon E, Dec KL, Caldwell M. Lower limb pain and dysfunction. In: Cifu DX, ed. Braddom's Physical Medicine & Rehabilitation. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 36.

Riff AJ, Chalmers PN, Bach BR. Knee diagnosis and decision-making. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine: Principles and Practice. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 90.

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Review Date: 6/13/2021  

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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