1 September 2020
IT Band Syndrome: Why does my outside knee hurt?
IT Band Syndrome Explained:
During the COVID-19 lockdown, many of us have found renewed commitment to staying fit. Some of us are running or cycling more frequently than before and some have taken it up again after not having cycled or run in years. If you happen to be one of them, perhaps you are now experiencing pain on the outside of the knee (as opposed to the inner side) and, occasionally, the outside thigh?
A common knee injury for runners and cyclists is the iliotibial band syndrome (also known as IT band syndrome, ITB syndrome or ITBS). This is a repetitive strain injury that causes pain mainly on the outside of the knee, especially when walking or running downhill. A tell-tale sign is mainly sharp or hot pain on the lateral side of the knee, also a spot that is sensitive to poking pressure, however it can radiate along the length of the IT band.
It’s not to be confused with the other runner’s knee, patellofemoral pain, which causes pain on the front of the knee.
The iliotibial tract (aka IT band) is a large thick band of connective tissue that runs down the lateral surface of the thigh and inserts at the knee. At the upper lateral thigh, the IT band has a relationship with the tensor fascia lata (TFL) and gluteus maximus muscles as well as laying on top of the vastus lateralis muscle above the knee.
The role of the IT band is to help with hip stability and provide movement of the hip and knee.
It’s a good question with no clear answer based on research. Based on my experience, there is a postural element to the problem, which can lead to an imbalance at the pelvis and increased tension in the TFL and vastus lateralis following repetitive hip and knee usage e.g. running or cycling.
The first thing is to assess your posture and examine active and passive movements in the lower back, hip, knee, foot & ankle to diagnose if it is indeed iliotibial band syndrome or there is another cause for the symptoms.
The treatment itself will then be tailored to the individual and include soft tissue massage, stretching and joint mobilisation as well as guidance to manage the symptoms at home with heat/cold therapy, stability and mobility exercises.
In summary, IT band syndrome is a common overuse condition in runners and cyclists, however, it may be experienced in inactive people e.g. after knee surgery. A treatment approach which focuses on the reduction of pain and inflammation and includes stretching and strengthening generally works best.