Physical Therapy in Congress Park, Denver Downtown, Central Park, and Highlands Area for Knee
Welcome to Atlas Physical Therapy's patient resource about Iliotibial Band Syndrome.
Iliotibial band (ITB) syndrome is an overuse problem that is often seen in bicyclists, runners, and long-distance walkers. It causes pain on the outside of the knee just above the joint. It rarely gets so bad that it requires surgery, but it can be very bothersome. The discomfort may keep athletes and other active people from participating in the activities they enjoy.
This article will help you understand:
how ITB syndrome develops
how the condition causes problems
what treatment options are available
Hear from some of our patients who we treated for Knee Pain
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Alex and his staff recently helped me with a knee injury and frozen shoulder. A couple years ago they helped me after my neck surgery. I am very pleased with the results and highly recommend their... ”
“ Alex and his staff recently helped me with a knee injury and frozen shoulder. A couple years ago they helped me after my neck surgery. I am very pleased with the results and highly recommend their services. ”
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By far the best physical therapists I have ever gone to! Alex and Kate have fixed everything that has come up from foot issues, to knee problems to all the tiny little things that happen during... ”
“ By far the best physical therapists I have ever gone to! Alex and Kate have fixed everything that has come up from foot issues, to knee problems to all the tiny little things that happen during training or just life in general. Lexi and Emma are awesome at making sure im doing exercises correctly and making it fun at the same time. With the help of everyone at Atlas Physical Therapy I was able to complete my first ultramarathon and look forward to completing many other ridiculous goals. ”
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Very professional people! Nikhil and Frank were respectful and yet personable in my time with them. I went in with a hurt knee that kept me from running. They were very conscientious about my desire... ”
“ Very professional people! Nikhil and Frank were respectful and yet personable in my time with them. I went in with a hurt knee that kept me from running. They were very conscientious about my desire to run again and worked hard to that end. I recommend them highly. ”
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I have been going to Atlas Physical Therapy for years, alas for different body parts. Each time I have gone, for various body parts (knee, shoulder, and now hip), Atlas has been there for me. You... ”
“ I have been going to Atlas Physical Therapy for years, alas for different body parts. Each time I have gone, for various body parts (knee, shoulder, and now hip), Atlas has been there for me. You won't regret it. Hope to (not) see you there - to your health! ”
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Brett, will and the team were great to work with. I was rehabbing a knee injury and that were very knowledgeable, helpful and accommodating to my schedule to ensure I got the treatment and care... ”
“ Brett, will and the team were great to work with. I was rehabbing a knee injury and that were very knowledgeable, helpful and accommodating to my schedule to ensure I got the treatment and care needed. After a few sessions I saw great improvement in my knee and back to normal now. We highly recommend based on knowledge and skill alone but also super friendly fun and supportive staff along the way. ”
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Brett, Will, and the entire Atlas team made my experience a great one. When I began therapy, my knee pain was preventing me from doing the activities I love, but within just a few weeks of treatment,... ”
“ Brett, Will, and the entire Atlas team made my experience a great one. When I began therapy, my knee pain was preventing me from doing the activities I love, but within just a few weeks of treatment, my pain was reduced by at least 75%. Brett and Will did a great job not only challenging me to make progress quickly, but made the experience fun. On top of that, Atlas uses an app for your home exercises that makes your exercises easier to do and rewards you for consistency. Highly recommend! ”
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I am a runner and runners sometimes get hurt! Alex has magic hands. The man has helped me get through plantar fasciitis on both feet, hip and knee issues and a pulled hamstring! All while keeping it... ”
“ I am a runner and runners sometimes get hurt! Alex has magic hands. The man has helped me get through plantar fasciitis on both feet, hip and knee issues and a pulled hamstring! All while keeping it fun and just being an amazing coach. If something ails you- go see him! He has magic hands and will get you back on track in no time ”
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Forever grateful for this place and getting my knee back up in order after repeat injuries. I recommend seeing like for any PT needs. Great place for overall recovery in addition to dry needling. I... ”
“ Forever grateful for this place and getting my knee back up in order after repeat injuries. I recommend seeing like for any PT needs. Great place for overall recovery in addition to dry needling. I hope not to spend much time back here but in case I do, it’s handy to have a trusted PT near work in downtown. ”
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I went to Atlas PT for what ended up being a torn meniscus. While we worked on heeling/getting stronger I had two friends who also torn their meniscus and quickly opted surgery. I had my moments... ”
“ I went to Atlas PT for what ended up being a torn meniscus. While we worked on heeling/getting stronger I had two friends who also torn their meniscus and quickly opted surgery. I had my moments where I wanted to do the same but Alex was super patient with me, making sure I understood my options and then supported me with whatever I choose. Lexi was great as well, showing me new strength building exercises and always took the time to answer questions I had about workouts outside of PT.I will always recommend Atlas PT to friends and family. They are knowledgeable and willing to work around your schedule (early mornings, and some early evenings.) ”
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Andrea and Nate were such an amazing team in helping me recover from my dislocated kneecap. They are patient, kind, encouraging, and truly cared in helping me make progress in my recovery. They helped... ”
“ Andrea and Nate were such an amazing team in helping me recover from my dislocated kneecap. They are patient, kind, encouraging, and truly cared in helping me make progress in my recovery. They helped me go from 2 crutches, to 1 crutch, to no longer wearing a knee brace/tape, and finally being able to walk normally again within 4 months. I would highly recommend this team to anyone!
This is a really nice, fun office that made me feel good about going in every appointment. I also appreciate Cat's kindness and stellar customer service at the front desk. ”
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It was all my fault, I waited until my knee tendonitis was so bad I could barely walk. At my age (63) you would think I should know better. But the team at Atlas did a remarkable job of putting me... ”
“ It was all my fault, I waited until my knee tendonitis was so bad I could barely walk. At my age (63) you would think I should know better. But the team at Atlas did a remarkable job of putting me back together. After the third visit I felt substantial improvement. They gave me some new stretches to do on a daily basis, and made some minor modifications to my current exercise program that will prevent this from reoccurring. Of course it was completely up to me to do the stretches and exercises, Luke and Hanna can’t do them for me. But by following their directions I am fully back on my feet and enjoying the summer. ”
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I worked with Andrea and Nate for almost 3 months to rehab after a meniscectomy. They were great from start to finish, always taking the time to assess progress and constantly tweaking my workout... ”
“ I worked with Andrea and Nate for almost 3 months to rehab after a meniscectomy. They were great from start to finish, always taking the time to assess progress and constantly tweaking my workout regimen to continue challenging me. As an expert Andrea would explain what was going on with my muscles and ligaments and help me understand how certain motions can hurt/help. Nate was fun to talk with while going through the exercises and always took time to make sure the weight and # of repetitions was just right. Highly recommend this place and will be coming back when my other knee needs work, haha. ”
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My first PT experience was at Atlas! I tore my left ACL during a ski accident a few years ago and decided to get it replaced a year ago. Luke is the bomb and had me up and walking in a month! Also... ”
“ My first PT experience was at Atlas! I tore my left ACL during a ski accident a few years ago and decided to get it replaced a year ago. Luke is the bomb and had me up and walking in a month! Also gives the best advice for what you can/cant do and what you should focus on. Unfortunately I had a year long string of bad luck and tore my right ACL in a bike accident and had replacement surgery and then had my meniscus touched up a few months later. My year long recovery has been at Atlas and they haven’t let me down! Their times are always flexible and the people there are super fun and make the recovery process something to look forward to every week. Matt and Abby were also really fun and helpful and were great at keeping spirits up. I will definitely be coming back!! (fingers crossed I don’t tear anything else though!) ”
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I opted out of surgery after a traumatic knee injury and the team at Atlas has made my recovery both a successful and a positive experience. Shout out to Dillon, Tommy, and Lexi! Thank you! ”
“ I opted out of surgery after a traumatic knee injury and the team at Atlas has made my recovery both a successful and a positive experience. Shout out to Dillon, Tommy, and Lexi! Thank you! ”
The ITB is actually a long tendon. (Tendons connect muscles to bone.) It attaches to a short muscle at the top of the pelvis called the tensor fascia lata. The ITB runs down the side of the thigh and connects to the outside edge of the tibia (shinbone) just below the middle of the knee joint. You can feel the tendon on the outside of your thigh when you tighten your leg muscles. The ITB crosses over the side of the knee joint, giving added stability to the knee.
The lower end of the ITB passes over the outer edge of the lateral femoral condyle, the area where the lower part of the femur (thighbone) bulges out above the knee joint. When the knee is bent and straightened, the tendon glides across the edge of the femoral condyle.
Lateral Femoral Condyle
A bursa is a fluid-filled sac that cushions body tissues from friction. These sacs are present where muscles or tendons glide against one another. A bursa rests between the femoral condyle and the ITB.
Muscles or Tendons Glide
Normally, this bursa lets the tendon glide smoothly back and forth over the edge of the femoral condyle as the knee bends and straightens.
The ITB glides back and forth over the lateral femoral condyle as the knee bends and straightens. Normally, this isn't a problem. But the bursa between the lateral femoral condyle and the ITB can become irritated and inflamed if the ITB starts to snap over the condyle with repeated knee motions such as those from walking, running, or biking.
Irritated ITB
People often end up with ITB syndrome from overdoing their activity. They try to push themselves too far, too fast, and they end up running, walking, or biking more than their body can handle. The repeated strain causes the bursa on the side of the knee to become inflamed.
Some experts believe that the problem happens when the knee bows outward. This can happen in runners if their shoes are worn on the outside edge, or if they run on slanted terrain. Others feel that certain foot abnormalities, such as foot pronation, cause ITB syndrome. (Pronation of the foot occurs when the arch flattens.)
Recently, health experts have found that runners with a weakened or fatigued gluteus medius muscle in the hip are more likely to end up with ITB syndrome. This muscle controls outward movements of the hip. If the gluteus medius isn't doing its job, the thigh tends to turn inward. This makes the knee angle into a knock-kneed position. The ITB becomes tightened against the bursa on the side of the knee. This is also called a valgus deformity of the knee.
People with bowed legs may also be at risk of developing ITB syndrome. The outward angle of the bowed knee makes the lateral femoral condyle more prominent and can make the snapping worse. This condition is also called a varus deformity of the knee.
Symptoms
What does ITB syndrome feel like?
The symptons of ITB syndrome commonly begin with pain over the outside of the knee, just above the knee joint. Tenderness in this area is usually worse after activity. As the bursitis grows worse, pain may radiate up the side of the thigh and down the side of the leg. Patients sometimes report a snapping or popping sensation on the outside of the knee.
Diagnosis
The diagnosis of ITB syndrome can usually be made without any complicated tests. When you visit Atlas Physical Therapy, our Physical Therapist will take a history of the problem and ask about any other injuries that may have occurred in the past. Generally, no swelling is visible. The snapping sensation usually cannot be heard.
Pain on the outside of the knee can be caused from conditions other than ITB syndrome. Our Physical Therapist will perform an examination of the knee and will look at your entire leg. You may want to bring the shoes that you use to run or walk with you to your appointment.
Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the Physical Therapists at Atlas Physical Therapy have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.
Atlas Physical Therapy provides services for Physical Therapy in Congress Park, Denver Downtown, Central Park, and Highlands Area.
Our Treatment
Non-surgical Rehabilitation
Most cases of ITB syndrome can be treated with simple measures. When you begin your Physical Therapy at Atlas Physical Therapy, we will first use heat, ice, and ultrasound to help calm pain and inflammation.
During our Physical Therapy program the problems that are causing your symptoms will be evaluated and treated. Our Physical Therapist may use stretching and strengthening exercises, in combination with a knee brace, kneecap taping, or shoe inserts to improve muscle balance and joint alignment of the hip and lower limb. Your Physical Therapist will probably ask you about your sport activities and may give you tips on your warm up and training schedule, footwear, and choices of terrain.
A key element of our treatment is examining your training schedule. Your Physical Therapist can work with you to adjust the distance you run, your footwear, and the running surfaces you choose.
We may recommend foot orthotics to improve your foot and lower limb alignment. Wearing orthotics in your shoes may allow you to resume normal walking immediately, but you should probably cut back on more vigorous activities for several weeks to allow the inflammation and pain to subside.
Our Physical Therapist will choose strengthening and stretching exercises to correct muscle imbalances, such as weakness in the gluteus medius muscle or tightness in the ITB.
Treatments such as ultrasound, friction massage, and ice may also be used to calm inflammation in the ITB. Our Physical Therapy sessions sometimes include iontophoresis, in which our Physical Therapist uses a mild electrical current to push anti-inflammatory medicine to the sore area. This treatment is especially helpful for patients who can't tolerate injections.
Although recovery time varies, if your treatment is nonsurgical, you should be able to return to normal activity within four to six weeks.
Post-surgical Rehabilitation
If you've undergone surgery, our Physical Therapist will create a personalized plan for your rehabilitation. You will first have a period of rest, which may involve using crutches. Then we will start you on a careful and gradual exercise program.
At Atlas Physical Therapy, our goal is to help you keep your pain under control, improve muscle and joint alignment, and return you to your sport or activity without additional problems. When your recovery is well under way, regular visits to our office will end. Although we will continue to be a resource, you will be in charge of doing your exercises as part of an ongoing home program.
Atlas Physical Therapy provides services for Physical Therapy in Congress Park, Denver Downtown, Central Park, and Highlands Area.
Surgery
Surgery is rarely needed to correct ITB problems. Surgery consists of removing the bursa and releasing, or lengthening, the ITB just enough so that the friction is reduced when the knee is bent and straightened.
