It's funny how the body works, sometimes. The iliotibial band is a long, thin, fibrous tissue running from your hip to the outside of your knee, but when it acts up, the only part that suffers is the outside edge of your knee. So although you feel like you have a knee injury, the problem actually originates in the hip. Weird. If your hip muscles aren't strong enough to support your leg movement, it stresses out your IT band, which ends up rubbing on that bump on the end of your femur next to your knee, causing you pain. Anything causing your legs to operate on different levels—i.e., differing leg lengths, shoes with worn-out soles, or sloped ground—can also result in iliotibial band syndrome. Athletes who use repetitive leg motions, like cyclists and runners, often find themselves with IT band syndrome. It's especially common in runners who don't cross-train, resulting in strong leg muscles, but weak hip and core muscles. I've had it, and lucky for you, I've also found out how to get rid of it.
Treatment for Iliotibial Band Syndrome
Exercise properly to reduce the risk of IT band syndrome. All those things that can cause iliotibial band injuries that I just mentioned? Don't do them. Start with good shoes, and replace them when they're worn out. Run on flat, even surfaces, and make sure you're running with good form by not turning your foot too much inward or outward when it hits the ground. Stretch your muscles out properly and don't focus on working just one or two muscle groups. Strengthen your weaker areas to balance out your body and improve overall athletic performance.
When the pain starts, relax your workouts and try R.I.C.E. To ease pain and reduce swelling, R.I.C.E.—rest, ice, compression, and elevation—is always good advice. You can keep exercising, but go easy and try a different activity that won't irritate your inflamed IT band. Apply ice wrapped in a towel or something for 20 minutes at a time a few times a day, or try massaging your knee with a big old ice cube for 5 minutes. Heaven. Bracing probably isn't necessary for minor IT band injuries, but elevating your leg can reduce swelling.
Stretch and strengthen your hips and IT band. This should clear up your pain and keep it from coming back, as long as you maintain your new strength and flexibility. Specifically, you're going to want to work on your upper leg muscles, your hip muscles, and the iliotibial band. Even though it's just your IT band acting up, all of these muscles need to be in tip-top shape to solve your problem and to reduce future injury. A certified physical therapist can give you a routine, but I've listed some simple exercises in the sidebar as a starting place.
Doctors can provide more in-depth care for your pain. If you have severe pain, if you're a professional athlete, or there is some other reason that you just have to be at your physical best, go to your doctor. He or she can diagnose your problem and give you a prognosis and detailed plan of care. Treatment for your IT band injury can include anti-inflammatory pain killers, physical therapy, massage, and cortisone injections. Ultrasound might be performed, where sound waves are directed toward the painful area, creating heat deep in your muscle tissue.
Have patience and stick to the plan. Possibly some of the most irritating advice ever to be given, but necessary. If you push yourself too hard, you're only going to hurt more. Depending on the severity of your IT band syndrome, you might be out of commission for a couple weeks or even two months. And don't skip out on the stretches and exercises after you start them. It's easy to get busy with other things and take a day off from them, but that's a slippery slope, my friend.
Physical Therapy Guidelines
Remember that even though it's your knee hurting, as you do these exercises you'll feel it in your hip and in the iliotibial band, running from your outer knee up to your hip, depending on which one you're doing. All of the IT band stretches and exercises mentioned here are discussed in terms of your injured leg, but it's a good idea to do them on both sides. You want balance in your body's strength so that it functions at its best, and to avoid problems on your other side. The suggested repetitions are a place to start; add more if they're too easy. There is no set number of days that you'll have to rehabilitate yourself—go with what your body tells you. When your pain is gone, your legs/knees/hips are equal in strength, and there isn't a trace of a limp in your step, you should be good to go. Also, when researching your injury, don't search for "IBS" in your favorite search engine, as I mistakenly did when my knee hurt. Maybe you do have irritable bowel syndrome, but those treatments won't help your IT band.