The Medicine Cabinet: Ask the Harvard Experts
By Robert H. Shmerling, M.D.
Q: I developed pain along the outer surface of my knee. A friend says I probably have ITB syndrome. What does that mean? How is it treated?
A: Short for iliotibial band syndrome, ITB syndrome refers to a common cause of knee pain.
The iliotibial band is a tough fibrous (scar-like) tissue that extends from the region of the hip to the knee along the outside of the leg. Along with other muscles of the leg, the IT band helps stabilize the knee, especially when the knee is stressed during physical activity.
ITB syndrome develops when there is damage, irritation or inflammation of the IT band. The most common site is at the outside of the knee where the tissue of the IT band rubs over a bony bump.
Pain over the outside of the knee is the most common symptom, although some people complain of pain higher up, along the outside of the thigh or hip. Repetitive knee flexing tends to make it worse. Rest usually relieves the symptoms.
While ITB syndrome may occur in anyone for no apparent reason, it’s more common among people who are young or middle age athletes, particularly if they are not very flexible. Also, people that are bow-legged, have flat feet or have legs of unequal length are more prone to this condition.
ITB syndrome is more likely to happen after engaging in activities that require repetitive flexing and extending of the knee. That’s why runners tend to have this problem, especially if they have recently increased their exercise intensity, such as upping the miles they run.
Treatment options include:
–adjusting one’s exercise routine
–physical therapy that includes stretching and strengthening exercises
–applying ice to the area where you feel the strongest pain
–improving footwear (including using shoe inserts for flat feet)
–anti-inflammatory medications (such as ibuprofen or naproxen)
In cases where these measures don’t work, doctors may recommend a cortisone injection or even surgery to remove a bony bump that’s irritating the IT band.
(Robert H. Shmerling, M.D., is associate professor of medicine at Harvard Medical School and clinical chief of rheumatology at Beth Israel Deaconess Medical Center in Boston. For additional consumer health information, please visit www.health.harvard.edu.)