Iliotibial Band and Orthotics

The iliotibial band is a large fascia band running from the external pelvis margin to the tibia in the lower leg. It extends down the outside leg between these two points and is also known as the IT band. The IT band provides hip motion and stabilizes the knee and the muscles that attach to it. 

Iliotibial Band Friction Syndrome (ITBFS) is a common condition in athletes, runners, and other people who expose their legs and knees to repetitive strains, whatever the reason. It is an injury caused by overuse of the leg and knee. 

IT band pain usually results from repetitive friction at the point where the IT band crosses the knee. It can also be caused by consistent compression of the fat pad located between the lateral knee (on the side) and the IT band. 

ITBFS can be exacerbated by a number of factors, such as increased running distances, a sudden increase in the intensity or volume of exercise, not warming up properly before physical activity, excessive foot pronation, muscular tightness or inflexibility, and more.  

Symptoms of ITBFS

The symptoms of IT Band Friction Syndrome appear in the outside or lateral portion of the knee and may include:

  • Muscular tightness
  • Swelling
  • Stiffness in the knee and leg when you wake up
  • Pain while flexing the knee

Another symptom is a sharp or dull pain in the knee, usually beginning after the onset of activity. It will typically persist even if you stop.


Risk Factors 

  • Running or other high-intensity activities
  • Poor running mechanics
  • Increasing running mileage
  • Increasing training intensity
  • Activities with sudden changes in direction
  • Side-to-side movement
  • Poorly fitting or worn-out shoes
  • Uneven terrain
  • Unsupportive footwear, such as sandals
  • High impact and high intensity or volume of exercise
  • Your mechanics

Depending on your mechanics, being obese or overweight can exacerbate the strain on the tendons and muscles in your lower legs.
You could also be predisposed to this type of condition. If you feel this might be the case, talk to a physician. 

Treating IT Band Friction Syndrome

The first line of defense for most people is the family doctor (general practitioner). They can help by recommending lifestyle changes and medications, if needed, or referring you to another medical professional for treatment.

Support from custom orthotics

Support from custom-made orthotic inserts can help with this condition. They deal with mechanical problems resulting in abnormal rotation of the femur and tibia that tighten the IT band. They can relieve tenderness and pain in the high-pressure areas of the foot. You can feel improvement in conditions such as shin splints, Achilles tendonitis, plantar fasciitis, arthritis, chondromalacia patella, and more.

Foot orthotics are insoles and shoes that address issues related not only to foot pain and leg pain but also bunions, leg length differences, back pain, leg tiredness, and other foot-related problems. They are custom-made to meet each person’s specific needs.

Physiotherapists, kinesiologists, pedorthists, massages

Physiotherapists can help with stretches, exercises, or lifestyle alterations. Pedorthists can assist by teaching you how to control foot motions that increase the pressure on the IT band and connected tissues.

A kinesiologist can help you ensure your workplace and living environment are conducive to healthy movement and posture.

Finally, you can see a massage therapist for interventions to reduce muscular stiffness or discomfort.

How to stay active despite an IT band condition

Avoid any activities or exercises that provoke or intensify your symptoms. These usually include cycling and running. They are repetitive, which makes them common IT band syndrome triggers. You’re at increased risk if you are a long-distance cyclist or runner active all year round. Many athletes keep training despite IT band pain, but this can lead to bigger risks in the long run.

To promote recovery without having to cease all activity, you can reduce the frequency, intensity, or mileage until symptoms improve. Adjust form and biomechanics to limit knee strain and strain on adjacent tissues like the glutes, quad, and hamstring. 

Make adjustments to your routine 

You can adjust your bike or run on a different surface and try cross-training to change how you use your muscles while still maintaining your strength and fitness level. Walking and swimming are great for the joints and muscles.  

Never skimp on quality footwear, including orthotics, if recommended. 

Squats and lunges are best avoided if you have IT band pain. The knee is quite painful in the area where the IT band attaches when it is bent between 30 and 90 degrees.

Depending on the severity of your symptoms, you might consider taking a break or modifying the above options. Ideally, begin with a limited, almost pain-free range of motion and work from there.

About foam rolling

A foam roller is a useful tool to address tender spots within connective tissue and muscle – if you can tolerate it. You might find it hard to manipulate the IT band itself, but applying a foam roller together with other treatment options can help you recover more quickly.

However, foam rolling is ineffective and can even be dangerous if you’re not doing it properly. The IT band is a very thick strip of tissue that requires a lot of pressure to manipulate. Foam rolling exercises are uncomfortable when the area is still painful.

If the IT band rolling is not providing any relief, you can focus on the other muscles, like the quads, the hamstrings, and the glutes, during as well as after the activity.

One thing that’s typical of soft tissue injuries is that after you warm up the tissue, it will often feel painless as you perform physical activity. When you stop, the discomfort will set in again. This might also happen after you rest. The discomfort can return when you get up the following day.

If this is the case, limit the duration or intensity of the activity until you reach a point where you don’t experience adverse symptoms.

Ask Mobility on Mainway about orthotics and IT band treatment 

Mobility on Mainway specializes in orthotics, footwear, and foot treatments. We can help alleviate your IT band problems by equipping you with the most effective, customized orthotics for your needs.  


Contact Mobility on Mainway

If you would like to talk to a specialist, contact Mobility on Mainway by filling out the contact form below or calling us to speak with our team.

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