ITB or Not ITB…That is The Question

by in Chiropractic Care, Physical Therapy and Rehab October 24, 2013

Anatomy of ITB Syndrome


Anatomy: the IlioTibial Tract is a very thick band of fascia that connects muscles of the hip (Gluteus Maximus & Tensor Fascia Latae) to the lower leg. It runs along the outside part of the knee and has a bursae (fluid filled sac) that lies underneath it to reduce friction as the knee bends and straightens.

Symptoms of “ITBand Syndrome”

·         Pain on the outside of the hip &/or knee

·         Usually worse with going downhill/ stairs

Contributing Factors- identifying the cause of tension:

The ITBand cannot contract by itself like a muscle. If the muscles it attaches to are weak or tight, then the tension is transferred to the ITBand. Therefore, correcting muscular imbalances can help alleviate the pressure placed on the band as it crosses the hip and the knee.

ITB Dysfunction is caused by biomechanical dysfunctions.

1) Hip Flexor Imbalance

Poor hip flexor (Iliopsoas) function can result in compensatory firing of Tensor Fascia Latae, which becomes hypertonic and shortened over time. Thus the origin of the ITBand is moved away from its insertion at the knee, increasing its tension. It is important to target hip flexor and quadriceps (Rectus Femoris) flexibility with massage and stretching.

2) Dynamic Knee Valgus

This position occurs when the knee buckles inward especially when bending. Once again, the insertion point moves away from the origin at the hip, causing more tension in the ITBand. The most common contributing factors to this positional fault are hip weaknesses (Gluteus Maximus and Medius) and excessive pronation or flattening of the foot which causes the knee to track inward.

3) Contralateral Pelvic Drop 

When standing on one leg (note: 80% of your gait cycle involves single leg balance), it is important for your pelvis to remain stable. If your hip drops downward, then it is important to work on strengthening the Gluteus Medius (stance leg) and the External Oblique and Quadratus Lumborum (non-stance leg) which helps control pelvic alignment for dynamic mobility.

Are you suffering from ITB Syndrome? Contact our office at 865-524-1234. Our physical therapists will help you get back to the activities that you love.