Knee Pain: IT band or something else?

author : AMSSM

comments : 0

I have a tight IT band on my left leg, but my right knee's pain is in a slightly different area, more in the joint, on the outside of the knee. Is this still an IT band issue?

Member Question

I have a tight IT band on my left leg, but my right knee's pain is in a slightly different area, more in the joint, on the outside of the knee.  Is this still an IT band issue?

Answer by Billy Haug, MD, CAQSM, CSCS
Member AMSSM

Knee pain on the lateral, or outside, aspect of the knee in runners is common.  It is important, however, to consider other etiologies that may cause pain in the lateral knee besides iliotibial band injuries.

The iliotibial band is a thick band of connective tissue (fascia) that crosses the hip and the knee joint and inserts on the lateral aspect of the tibia (large bone of the lower leg) just below the kneecap.  Repetitive flexion and extension of the knee while running can cause the iliotibial band to become irritated and inflamed resulting in lateral knee pain.

Iliotibial band issues will most likely respond to conservative treatment involving stretching of the iliotibial band, strengthening of the gluteus medius, and modifying your training routine.  Consider being evaluated by a physician trained in sports medicine in combination with physical therapy.  Some athletes also benefit from orthotics for their shoes to prevent further injury.

Corticosteroid injections may be considered if the pain persists despite therapy and time.  A small percentage of athletes do not respond to conservative treatment and may require surgical release of the iliotibial band for resolution of their symptoms. 

If you feel that you have attempted sufficient rehabilitation regarding the iliotibial band, you may want to consider other etiologies of your pain.  The lateral meniscus is a cartilage pad which acts like a shock absorber in the knee.  Injury to the lateral meniscus can be confused with injury to the iliotibial band.  You may need an MRI to assess the meniscus and make sure that it is not torn.  A stress fracture, hamstring tendonitis, or referred pain from the lower spine may also cause an athlete to have lateral leg pain. 

Running should be resumed only after you can do your exercises without pain.  A gradual return, starting at an easy pace, is very important.  Increase your mileage slowly, and resume normal mileage following a modified training program to ensure your safe return to sports.  You will hopefully see improvement within three to six weeks after starting your rehab program.

Billy Haug, MD, CAQSM, CSCS
Altru Health System
Sports Medicine
Grand Fork, ND

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date: May 29, 2012