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ITB (Iliotibial Band) Syndrome

Dr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.

Notably a runner’s injury, ITB syndrome (iliotibial band friction syndrome) is classified as an overuse injury. This is when there are repetitive sliding movements of the ITB across the femoral condyle, which is a small bone on the outside of the knee. Varying degrees of friction are created as an individual runs, especially when the knee is bent within the impingement zone. This zone describes the degree of flexion (30 degrees) in which structures on the outside of the knee are pinched or compressed. As a visual, this point of flexion typically occurs just as the foot touches the ground.

While ITB syndrome results from repeated impact or trauma, such as excessive marathon training or training downhill, there remains a pattern of causes that center on poor technique and weak muscles. Consider the following common causes of ITB Syndrome:

  • Poor running technique (biomechanics)
  • Weak hip or gluteal muscles
  • Weak hip rotators
  • Weak inner thighs or quadriceps
  • Weak core or abdominal muscles
  • Poor foot arch

Depending on the circumstances and the level of injury, the following are common symptoms associated with ITB syndrome:

  • Burning pain above the outer part of the knee
  • Increased pain while running
  • Swelling and inflammation
  • Pain while bending the knee
  • Symptoms that manifest gradually

Treatment and Rehabilitation for ITB (Iliotibial Band) Syndrome

Physiatrists are well-positioned to identify and assess those with knee pain, such as ITB syndrome. They consider multiple body systems and a wide variety of conditions in order to optimize patient care and enhance quality of life.

For the most part, physiatrists favor conservative, nonsurgical treatment protocols. Thus, using tried and true methods such as rest, ice therapy and medication (NSAIDS), initial treatment focuses on reducing pain and inflammation. While this provides relief to patients by lessening their discomfort, physiatrists derive important diagnostic information relating to the patient’s condition by noting their response to early pain reduction techniques.

Once pain and inflammation become managed, patients are able to tolerate rehabilitation, as directed by the physiatrist. Physical therapy proves invaluable as therapists guide patients through carefully selected exercises and stretches that are safe variations to de-load the IT band. An example is performing box squats in place of quad-dominant squats. Along with normalizing joint range of motion, strengthening muscles of the lower extremities and stretching to normalize muscle lengths, patients are guided through balance and agility exercises. With a comprehensive approach, physiatrists also incorporate lifestyle training and patient education in regard to body mechanics. For instance, modifications are made to an individual’s running and landing technique. This is as well as position, posture and intensity.

While pain management and reducing inflammation is an important part of recovery from ITB syndrome, physiatrists understand the long-term power of comprehensive rehabilitation. When individuals engage in therapy that works to restore the body as a whole, they are healthier and stronger, physically and mentally.

At the Howard Liss, M.D. Rehabilitation Institute in Tenafly, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their functioning.

If you are suffering from pain in your knee, and you believe that it is ITB syndrome, contact the Howard Liss, M.D. Rehabilitation Institute today. 


Rehabilitation Institute

111 Dean Drive Suite 1
Tenafly, NJ, 07670
Fax: (201) 871-2214

Call Us: (201) 390-9200