Ilio-Tibial Band Syndrome / ITB Syndrome

Ilio-Tibial Band Syndrome / ITB Syndrome

What Is the Ilio-Tibial Band?

The ilio-tibial band (ITB) is a thick fascia running from the pelvis down the lateral aspect of the thigh down to the outer aspect of the knee at the proximal tibia known as the Gerdy’s tubercle.

What is ITB Syndrome?

ITB Syndrome is a FRICTION / OVERUSE injury when the ITB fascia is painful due to it rubbing against either the bony prominence on the outer aspect of the knee joint (called the lateral epicondyle).

How To Diagnose ITB Syndrome?

ITB syndrome is diagnosed with a combination of careful history taking and physical examination. The physical examination should show tenderness of the lateral aspect of the knee at the lateral epicondyle.

Ober’s test can be positive. Ober’s test is a physical examination test that shows tightness of the ilio-tibial band. A tight ilio-tibial band is expected to result in more friction and rubbing of the fascia against the lateral epicondyle of the knee.

Ober’s Test

With the patient lying in the lateral position, support the knee and flex it to 90 degrees. Then extend and abduct the hip. Then release the knee support. Failure of the knee to adduct is a positive test. The examiner places a stabilizing hand on the patient’s upper iliac crest and then lifts the upper leg, which is flexed at the knee, extends it at the hip, and slowly lowers it toward the bottom leg, allowing the thigh to lower towards the table. The examiner must continue to stabilize at the hip to ensure there is no movement. The test result is positive if the patient is unable to adduct the leg parallel to the table in a neutral position.

ITB syndrome is more common in:

  • Runners
  • Cyclists

Investigations

MRI of the knee joint can sometimes show fluid and oedema of the ilio-tibial band adjacent to the lateral epicondyle of the knee.

MRI showing ITB Syndrome of the left knee.

Treatment

Ilio-tibial band stretches

Deep tissue massage of the ilio-tibial band.

Cortisone injection.

Physiotherapy.

Oral anti-inflammatory medications.

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