Iliotibial Band (ITB) Syndrome Treatment Options

What is ITB Syndrome?

Iliotibial band (ITB) syndrome is a common overuse injury characterized by inflammation and irritation of the iliotibial band, a thick band of connective tissue that runs along the outside of the thigh from the hip to the knee. This condition typically occurs in athletes and runners, especially those who engage in repetitive motions such as running or cycling. ITB syndrome can cause pain and discomfort on the outer side of the knee joint, limiting performance and impacting daily activities.

How is ITB Syndrome treated?

Addressing ITB syndrome involves reducing pain, inflammation, and restoring knee function. Initially, conservative measures like rest, ice therapy, and targeted exercises are employed. Stretching, strengthening, and foam rolling can alleviate tension and correct muscle imbalances. Custom orthotic devices may aid in supporting the knee joint. Physical therapy offers tailored exercise programs and manual therapy techniques. In more severe cases, corticosteroid injections or surgery may be considered, but are typically reserved for refractory cases.

What Non-Operative Options Are Available?

• Rest and Activity Modification: Avoiding activities that exacerbate symptoms and gradually reintroducing low-impact exercises once pain subsides.
• Ice Therapy: Applying ice packs to the affected area to reduce inflammation and alleviate pain.
• Stretching and Foam Rolling: Gentle stretching exercises targeting the ITB, hip flexors, and quadriceps muscles to improve flexibility and reduce tension.
• Strengthening Exercises: Specific exercises to strengthen the hip abductor and gluteal muscles to improve biomechanics and reduce stress on the ITB.
• Orthotic Devices: Custom orthotic inserts or footwear modifications to correct foot mechanics and reduce excessive pronation, which can contribute to ITB syndrome.
• Biomechanical Evaluation: Assessing gait and running mechanics to identify and address any abnormalities or inefficiencies that may predispose individuals to ITB syndrome.
• Manual Therapy: Hands-on techniques such as massage or myofascial release to alleviate muscle tightness and improve tissue mobility.

What operative options are available?

In rare cases where conservative treatments fail to provide relief, surgical intervention may be considered. Surgical options for ITB syndrome are typically reserved for severe or refractory cases and may include:

• ITB Release Surgery: Surgical release of the iliotibial band to reduce tension and alleviate friction on the lateral aspect of the knee joint.
• Bursectomy: Removal of inflamed bursa tissue near the ITB to reduce pain and inflammation.

What does rehabilitation look like?

Post-treatment rehabilitation is essential to restore optimal knee function and prevent recurrence of symptoms. Physical therapy plays a central role, focusing on strengthening the hip abductors and external rotators, as well as improving flexibility and mobility of the ITB and surrounding muscles. Functional exercises aim to enhance biomechanics during activities like running or cycling. Gradual return to activity is guided by the therapist, with emphasis on proper form and avoiding overloading the ITB. Patient education on self-management strategies and ongoing monitoring ensure long-term success in managing ITB syndrome.

In conclusion, effective management of ITB syndrome requires a multifaceted approach that addresses biomechanical issues, reduces inflammation, and promotes tissue healing. By combining conservative treatments with targeted rehabilitation strategies, individuals with ITB syndrome can achieve pain relief and return to their desired level of activity. Dr. Shane J. Nho is a board-certified fellowship trained sports medicine orthopaedic surgeon who specializes in the treatment of gluteus medius and minimus tears. If you believe you are affected by a gluteus medius and minimus tear, schedule a consultation today with our experienced orthopaedic care team.

Dr. Shane J. Nho is a board-certified fellowship trained sports medicine orthopaedic surgeon who specializes in the treatment of ITB syndrome. If you believe you are affected by ITB syndrome schedule a consultation today with our experienced orthopaedic care team.