Iliotibial Band Syndrome (cont.)

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How is iliotibial band syndrome diagnosed?

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Often, the diagnosis of iliotibial band syndrome can be made by the patient's story of symptoms. The patient describes the progression of lateral knee pain that is made worse when the heel strikes the ground. Physical examination is helpful because the area of pain can often be palpated with tenderness and swelling felt over the femoral epicondyle where the bursa or sac is located.

The health care professional may also look for leg-length discrepancy and muscle imbalance in the legs and back. There is tenderness of the outer thigh just above the knee joint while the knee and hip joints are normal.

Usually, a full physical examination of the low back and legs, including the hips, knees and ankles, is performed to detect other potential causes of outer knee pain.

Blood tests and X-rays are usually not required.

What is the treatment for iliotibial band syndrome?

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Iliotibial band syndrome is an overuse injury that causes inflammation. Initial treatment includes rest, ice, compression, and elevation (RICE).

Anti-inflammatory medications, like ibuprofen (Advil, Motrin) and naproxen (Anaprox, Aleve), may be helpful. Please be aware that over-the-counter medications like these can have potential side effects and interactions with prescription medications and it is worthwhile asking your care provider or pharmacist whether they are safe to take.

Should treatments not work, physical therapy may be needed to decrease the inflammation at the IT band. Some treatments focus on flexibility and stretching. Friction rubbing may occur over the IT band at the femoral epicondyle to break down inflammation and scarring.

Therapeutic ultrasound techniques may be used, including phonopheresis (ultrasound propels anti-inflammatory medications through the skin into the inflamed tissue) and iontophoresis (electricity is used instead of ultrasound).

The physical therapist may also help evaluate the underlying cause of the problem and look at muscle strength and balance and/or flexibility and gait analysis (watching a person walk or run). Shoe orthotics may be useful if there is a gait problem, pelvic tilt, or leg-length discrepancy as a potential cause of IT band syndrome.

It is rare that the conservative nonsurgical treatment fails to help. However, orthopedic surgery may be an option for patients who fail conservative treatment. Arthroscopy can be used to find the inflammation surrounding the iliotibial band and cut it away. The IT band itself can also potentially be lengthened.


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