Iliotibial band friction syndrome (ITBFS)

Ilio-tibial band with red area showing the region of pain and tenderness

The iliotibial band is a tight fibrous band of tissue running down the outside of the thigh from the pelvis to the tibia. It can cause friction as it crosses bony prominences. The two problem areas are the greater trochanter at the hip (see trochanteric bursitis) and the lateral femoral condyle on the outside of the knee. It is an overuse injury seen most commonly in runners and cyclists. Tightness of the iliotibial band, biomechanical problems, or certain training factors can bring this problem on.

You will feel pain on the outside of the knee, aggravated by activities that involve bending and straightening the knee repeatedly, such as running and cycling. Initially it may be a dull ache near the end of a session, but as the condition progresses the pain may be present more of the time and take longer to go away.

If you think you have this condition it is well worth getting it checked out by Mr Willis-Owen. In the mean time you should avoid any aggravating activities which may prolong the problem. It generally won't get better on its own. The first thing to do is to reduce the problem activities. Anti-inflammatories and ice are helpful after exercise.

Treatment involves first confirming the diagnosis, then establishing the cause. Bike set up, running shoes, and running surfaces (road camber and track direction) can be causes. Treatment options may include very specific physiotherapy, shockwave treatment, injections, or rarely surgery can be required. Once you have recovered, good physio should be able to prevent this from coming back.