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Iliotibial Band Friction Syndrome

What is it?

Iliotibial band friction syndrome is a form of bursitis on either side, or lateral part, of the knee. Bursitis is the inflammation of a bursa, which is a fluid-filled sac that provides a cushion between a bone and tissues, such as a ligament.

Who gets it?

Iliotibial band friction syndrome is a common injury in cyclists and people who participate in physical activities that involve running.

What causes it?

The iliotibial band is a ligament that runs from the top of the hip to the outside of the knee. This ligament keeps the knee stable during activity such as running or riding a bike. Iliotibial band friction syndrome is caused by the iliotibial band rubbing against a projection at the end of the femur (thigh bone). This is more likely to occur in people who run on sloped surfaces, wear unsupportive running shoes, or have an abnormal running gait, all of which can cause the leg to bend inward. It can also be caused by overuse, not warming up sufficiently before exercising, an abnormally tight iliotibial band, or by popliteus tendonitis, an inflammation of the muscle that is located in the back of the knee joint. This muscle flexes the leg and helps with rotation.

What are the symptoms?

The main symptom of iliotibial band friction syndrome is a sharp, burning pain along each side of the knee after running or cycling. The outside of the knee may also be tender or swollen. The pain prevents the patient from continuing the physical activity, but usually goes away with rest.

How is it diagnosed?

Iliotibial band friction syndrome is diagnosed by its symptoms. Your doctor will ask about the type of physical activity you participate in regularly, and may press on the iliotibial band in the area where it joins the femur to check for tenderness.

What is the treatment?

To treat iliotibial band friction syndrome, your doctor will recommend rest from your normal athletic activities. Ice and nonsteroidal anti-inflammatory drugs will relieve swelling and pain. Once the pain is gone, your doctor can recommend stretching and strengthening exercises to regain mobility. With your doctor’s approval, you can then resume your running or cycling activities. However, he or she will recommend running on flat surfaces or adjusting the position of your bicycle seat or pedals to reduce stress on the iliotibial band. People with unusual gaits may need to wear special shoe inserts called orthotics to change the position of the foot during physical activity. Most patients can resume normal activities within two to four weeks. Patients whose pain is not relieved by this type of treatment may need to receive cortisone injections in the iliotibial band to relieve inflammation and pain. Surgery on the iliotibial band is only performed when all other measures fail.

Self-care tips

Most patients will recover completely if they follow the recommended treatment plan for iliotibial band friction syndrome. You can help prevent this condition by stretching before any physical activity and performing regular exercises to strengthen the muscles in the legs.


This information has been designed as a comprehensive and quick reference guide written by our health care reviewers.  The health information written by our authors is intended to be a supplement to the care provided by your physician.  It is not intended nor implied to be a substitute for professional medical advice. 

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This page was last updated on October 31, 2006
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