What causes IT band syndrome?

The iliotibial band, more commonly referred to as the IT band, is a long thick band of connective tissue that crosses both the lateral hip and knee joints. The IT band is helpful in stabilizing the lateral side of the leg, but can be blamed for many common hip and knee problems. But is the IT band itself really the problem?

The IT band originates in the lateral hip region on the iliac crest, crosses over the lateral hip, then crosses the knee joint and inserts on the lateral tibia. The IT band encloses the tensor fascia latae, and receives most of the tendon from the gluteus maximus. The IT band also attaches distally to several other structures, including the biceps femoris and vastus lateralis muscles, as well as attaching to the patella.

So, there are a couple of questions I want to address. The first question: does IT band tightness cause pain? As previously stated, the IT band is a thick band of connective tissue. Research has failed to show that the actual IT band can become shorter or longer. However, the muscles that attach to the IT band can become shortened or weakened, which causes the IT band to place pressure in areas that cause pain. For example, the IT band rubbing across the greater trochanter of the hip can cause inflammation, commonly known as hip bursitis. The IT band rubbing across the lateral knee can also cause pain, which is very common in runners. Other areas of dysfunction in the leg, such as faulty foot mechanics, can also place increased stress on the IT band during activities that require repetitive knee flexion and extension, such as running.

The next question to address: How do we treat pain that we feel is coming from the IT band? Again, the IT band itself is likely not the problem here. So be nice to it. Smashing your IT band along a foam roller may cause increased inflammation and although it may give you a temporary sensation of relief following foam rolling (or perhaps your IT band is just happy it isn't being smashed any more), it won't fix the problem. Because as stated before, the problem isn't a tight IT band. It is dysfunction elsewhere, likely in the hip or the foot/ankle, which is causing increased stress on the IT band.

So to really answer the question of what causes IT band syndrome, individuals experiencing this pain should have an individualized assessment. A movement professional should assess their range of motion, strength, and most importantly, watch them move. Addressing the dysfunction above and below the knee will likely resolve the symptoms of "IT band syndrome".

Are you limited by IT band syndrome or other hip, knee, or foot/ankle pain? Contact us today to schedule your individualized assessment.

Blog post written by Dr. Alexis Hutchison, PT, DPT, OCS