The iliotibial band (ITB)is a thickening of the fascia (tissue fiber). It runs along the outside of the thigh, from just above the hip to just below the knee.It envelops the whole of the thigh, much like a stocking. The ITB helps stabilize and move the knee joint. When the ITB is inflamed or weakened, movement of the knee becomes painful.The ITB could be considered the tendon of two muscles– the tensor fascia lata (TFL) in the front, and the gluteus maximus at the rear. These two muscles, which are also referred to as the “hip abductors,”act as the upper tensioning and positioning “brains” of the knee Often, weak hip abductors on one side of the body cause the opposite hip to drop when walking. Additionally, poor rear foot mechanics including hyper-pronation (turning inward and inside on the foot while walking) can cause excessive internal rotation of the tibia (shinbone).
This poor positioning means the ITB attachment at the knee ends up with more medial rotation (turning into the center of the body). This can create a cascade of painful reactions, as external environmental factors—the activities of daily life—add compression and act as shear (opposing) forces. Running on curved cement surfaces or circular tracks are two examples of activities that can intensify these ITB symptoms and pains.
The best treatment approaches for complications with the ITB focus on the gluteals and TFL (hip abductors),as these are the muscles pulling the ITB from the top and addressing the lower extremity, to eliminatenegative influence or force from the feet, lateral leg or calves.