Castro Domínguez Francisco

Iliotibial band syndrome is a common overuse injury that affects the outer side of the knee and hip. It is particularly prevalent among runners, cyclists, and individuals who engage in activities with repetitive leg motions. Understanding where and why it hurts when Iliotibial Band Syndrome occurs can help patients recognize the condition early and seek effective treatment.

The hallmark of Iliotibial band syndrome is pain along the outer side of the knee. This pain is typically felt where the iliotibial band—a thick band of connective tissue—passes over the bony prominence on the outside of the knee, called the lateral femoral epicondyle. The Iliotibial band runs from the hip to the shin, stabilizing the knee during movement, but irritation occurs when repetitive activities cause friction where the band rubs against the knee. In some cases, pain may also radiate up to the outer hip or down toward the shin.

The pain is generally focused on the outer knee and can extend up to the outer thigh and hip.

Iliotibial band syndrome pain is often described as sharp, burning, or stinging, especially during activities that involve bending and straightening the knee. It may initially feel like a mild ache, but with continued activity, it can become more intense.

The pain tends to worsen with activities that involve repetitive knee flexion and extension, such as running, cycling, or hiking downhill. Some patients report pain that comes on after a certain distance or amount of time spent running or biking.

Unlike some knee injuries, Iliotibial band syndrome pain may not persist when at rest. However, as the condition progresses, discomfort may linger after activity and can become noticeable even during daily movements, like standing from a seated position or climbing stairs.

The exact cause of Iliotibial band syndrome is multifactorial, often resulting from a combination of anatomical, biomechanical, and training factors:

• Repetitive friction: As the knee bends and straightens, the Iliotibial band slides over the lateral femoral epicondyle, which can cause irritation, particularly during repetitive activities.
• Muscle imbalance and weakness: Weakness in the hip abductors and glutes can lead to improper alignment of the leg, increasing the load on the IT band and making it more prone to irritation.
• Poor piomechanics: Improper running or cycling form, such as overpronation (rolling the foot inward), can contribute to abnormal stress on the Iliotibial band.
• Inadequate warm-up and stretching: Tight hip, thigh, and calf muscles can increase tension in the Iliotibial band, making it more susceptible to friction.
• Sudden increase in activity: A rapid increase in training intensity, distance, or frequency without proper conditioning can overload the Iliotibial band, leading to inflammation.