If you’ve ever experienced sharp pain along the outer thigh or knee while running, climbing stairs, or squatting, you may be dealing with Iliotibial Band Syndrome (ITBS). This common overuse injury affects the iliotibial band (IT band) — a thick strip of connective tissue that runs along the outside of your thigh, from the hip to the knee.
The IT band works with surrounding muscles to stabilize the hip and knee during movement. When it becomes tight or irritated from repetitive motion, friction develops between the IT band and the underlying bone, causing inflammation and pain.
At Dr. Burke Orthopedics, we provide accurate diagnosis and tailored treatment for IT Band Syndrome, helping patients across Pearland, Houston, Friendswood, and Southeast Texas overcome pain and regain mobility through advanced orthopedic care.
The iliotibial band is a thick, fibrous strip of fascia that originates at the iliac crest (hip bone) and runs down the outer thigh, attaching to the tibia near the knee. It acts as a stabilizer for the hip and knee joints during walking, running, and cycling.
When the IT band repeatedly rubs against the lateral femoral condyle (the bony part of the thighbone near the knee), the resulting friction leads to irritation and inflammation of the tissue — causing Iliotibial Band Syndrome.
Although it’s often associated with runners, ITBS can affect anyone who engages in repetitive leg motion, including cyclists, hikers, and manual laborers.
Causes and Risk Factors
IT Band Syndrome develops from repetitive stress and friction, usually due to tightness, muscle imbalance, or improper movement mechanics.
Common causes include:
- Overuse: Running, cycling, or climbing stairs without proper rest.
- Tight hip or thigh muscles: Reduced flexibility increases tension along the IT band.
- Weak gluteal muscles: Lack of hip stability shifts stress onto the IT band.
- Improper training technique: Overstriding, running downhill, or poor footwear.
- Muscle imbalance: Uneven strength between the inner and outer thighs.
- Leg-length discrepancy or pelvic tilt: Causes uneven tension during movement.
Risk factors include:
- Endurance athletes (runners, cyclists, rowers)
- Individuals who frequently sit for long hours
- Poor posture or gait mechanics
- Sudden increases in workout intensity or distance
- Flat feet or high arches
- Prior hip or knee injuries
IT Band Syndrome typically develops gradually, with symptoms that worsen during repetitive activity and improve with rest.
Common symptoms include:
- Sharp or burning pain along the outer thigh or knee
- Pain that worsens when bending or straightening the knee
- Tenderness or tightness on the outer leg
- A snapping or clicking sensation near the hip or knee
- Stiffness after sitting or sleeping
In advanced cases, pain may persist even during rest or normal daily activities.
At Dr. Burke Orthopedics, Dr. Robert L. Burke, a board-certified orthopedic surgeon, performs a detailed evaluation to confirm the diagnosis and rule out other causes of outer leg pain such as meniscus tears or hip bursitis.
Diagnostic process includes:
- Medical history: Discussion of symptoms, activity level, and recent changes in exercise routine.
- Physical examination: Palpation of the IT band, hip, and knee to identify tender points.
- Movement and flexibility testing: Determines how tightness or muscle imbalance contributes to friction.
- Gait analysis: Observes walking or running patterns for improper mechanics.
Imaging:
- Ultrasound: Detects inflammation along the IT band.
- MRI: Used to rule out structural damage to the knee joint or tendons.
This thorough approach ensures that the treatment plan addresses the root cause — not just the symptoms.
Treatment for IT Band Syndrome focuses on reducing inflammation, restoring flexibility, and correcting the mechanical issues that cause friction and irritation.
Non-Surgical Treatments
- Rest and activity modification: Temporarily stop high-impact exercise to allow the tissue to heal.
- Cold therapy: Ice the outer thigh or knee for 15–20 minutes to reduce swelling.
- Anti-inflammatory medication: Controls pain and inflammation.
- Soft-tissue therapy: Massage, myofascial release, or dry needling may help relieve tightness.
- Platelet-rich plasma injections help promote tissue healing and reduce chronic inflammation.
- Customized programs that include stretching, strengthening of the glutes and hips, foam rolling, and retraining movement patterns to reduce IT band tension.
Surgical Treatments
Surgery is rare but may be recommended for chronic cases that don’t respond to conservative care.
Procedures may include:
- IT Band Release or Debridement: Removes scar tissue or releases tension to prevent further friction.
- Reconstructive Surgery: In complex cases where other structures are affected or joint alignment needs correction.
Dr. Burke prioritizes non-invasive care first, with surgery reserved for persistent, resistant cases.
Recovery and Rehabilitation
Recovery time depends on the severity of inflammation and the patient’s commitment to therapy.
Typical recovery timeline:
- Mild cases: 4–6 weeks of rest and physical therapy.
- Moderate cases: 6–10 weeks with progressive strengthening.
- Severe or chronic cases: 3–6 months if surgery or advanced treatment is required.
Rehabilitation goals:
- Stretch and lengthen the IT band and surrounding muscles
- Strengthen glutes, hip abductors, and core muscles
- Improve posture and gait mechanics
- Gradually return to full activity without pain
Dr. Burke Orthopedics provides personalized rehabilitation programs designed to restore balance, flexibility, and long-term joint stability.
Long-Term Outlook and Prevention
Most patients fully recover from IT Band Syndrome with proper treatment and physical therapy. However, ignoring symptoms or continuing activity through pain can cause chronic irritation and recurring inflammation.
Prevention tips:
- Stretch before and after exercise
- Strengthen hip and core muscles to improve alignment
- Use proper footwear and replace worn-out shoes
- Avoid excessive downhill running or sudden training increases
- Take rest days between intense workouts
- Maintain flexibility with foam rolling or regular massage
Preventive care and balanced training techniques are key to avoiding recurrence.
You should seek orthopedic evaluation if:
- Pain persists despite rest or stretching
- The outer thigh or knee feels tight or tender during activity
- Pain interferes with daily movement or sleep
- You experience snapping, clicking, or stiffness that worsens over time
Early diagnosis helps prevent chronic inflammation and long-term mobility issues.
Take the First Step Toward Relief
If you’re experiencing outer thigh or knee pain that won’t go away, it may be time for professional evaluation.
At Dr. Burke Orthopedics, we provide expert diagnosis and comprehensive care to relieve IT band pain, restore mobility, and help you return to your active lifestyle.
We proudly serve Pearland, Houston, Friendswood, and Southeast Texas, combining advanced orthopedic knowledge with compassionate patient care.
Call (713) 436-3488 or Request an Appointment Online to schedule a consultation with Dr. Robert L. Burke, board-certified orthopedic surgeon specializing in lower extremity conditions and sports injuries.
