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Iliotibial Band Syndrome (IT Band)

knee pain in cyclists

Iliotibial band syndrome is most commonly seen in cyclists, runners and long-distance walkers.

Iliotibial band syndrome (ITB syndrome) is felt as pain on the outside of the knee (lateral knee pain) . This is caused by poor biomechanics and overuse, and is most commonly seen in cyclists, runners and long-distance walkers. The pain often gets progressively worse as the activity is continued.

What causes it?

The iliotibial band is a long tendon that runs from the hip to the outside of the knee. You can feel this tendon on the outside of your leg when you contract your leg muscles. It crosses the knee joint, which increases stability of the knee and passes over the bony bump on the outside of your knee (lateral femoral condyle). This is where the tendon glides across the edge of the knee with repeated bending of the knee joint.

When there are poor biomechanics or tightness in the surrounding muscles this repeated gliding can cause irritation, inflammation and pain. This can be from pushing yourself too much, increasing speed and/or distance too far and too fast.

Researchers have found that weakness of the hip muscles (gluteus medius) can cause this extra rubbing and irritation due to tightening of the outside of the knee.


The good news is that Iliotibial band syndrome can be treated very easily. Getting rid of the pain and inflammation with ice and ultrasound are the first steps.

Stretching of the hip muscles combined with strengthening of the gluteus medius muscle will help to restore proper biomechanics to the knee joint, and correct any muscle imbalances you may have. Use of a knee brace, kneecap taping or orthotics can also help to take pressure off of the knee and speed recovery.

Typically you will have to reduce your level of activity for 4-6 weeks depending on your reaction to treatment. You can then gradual increase your level of activity, assuming it does not increase the pain. The practitioner’s goal is to help you get out of pain faster, improve your muscle and joint alignment and get back to playing the sport you love. As you progress, your therapist should be giving you more responsibility to do your stretches and exercises to ensure that the problem is resolved and does not return.

Give our Waterloo chiropractic office a call to schedule an appointment and see how we can help you or someone you know.