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Rady Children's Specialists

Iliotibial Band Syndrome

Iliotibial (IT) band syndrome is a common cause of knee pain, especially in runners. The IT band is a long tendon that extends from the outer side of the pelvis (ilium) and runs along the side of the thigh to insert just below the knee on the upper part of the shin bone.

Pain can either occur at the insertion on the shin bone, or ins the pelvis. It usually occurs when the tendon gets inflamed from overuse. Certain activities have been associated with a risk for developing this syndrome and include an inadequate warm-up or cool-down, and increasing distance or speed too quickly.


The symptoms of IT band syndrome include:

  • Pain on the outside of the knee (or hip) that occurs with running and generally improves with rest.
  • A snapping sensation at the outside of the knee with running.


Symptoms and training habits will often provide the diagnosis in conjunction with the physical exam. An X-ray should be done to be sure that there is no bone injury or fracture. An MRI is rarely needed.


Treatment requires a period of rest from running or other painful activities. Six weeks of rest is often sufficient time to allow the inflammation to resolve and the tendon to heal. Ice and anti-inflammatory medication can help to perform stretching exercises.  Physical therapy and IT band massage may also help with hip muscle stretching as well as strengthening. Shoe inserts may be needed for low arches or excessive pronation.  Surgery is rarely needed. A return to sports (running) should be done gradually – a general rule to follow is to not increase distance, intensity or duration of training by more than 5 percent a week.