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Thigh it band: Iliotibial (IT) Band Syndrome of the Thigh | Advanced Orthopedics of Oklahoma

Iliotibial (IT) Band Syndrome of the Thigh | Advanced Orthopedics of Oklahoma

The Iliotibial band syndrome is pain in the outside upper thigh. The pain is due to an inflammation (soreness) of the iliotibial band. This is a band of thick fibrous tissue that runs down the outside of the thigh. The iliotibial band begins at the hip. It extends to the outer side of the shin bone (tibia) just below the knee joint. The band works with the thigh muscles. Together they provide stability to the outside of the knee joint.

Iliotibial (IT) Band Syndrome occurs when there is inflammation to this band of tissue. The irritation usually occurs over the outside of the knee joint, at the lateral epicondyle (the end of the femur bone.) The iliotibial band crosses bone and muscle at this point. Between these structures is a bursa (a cushioning sac). The bursa should make possible a smooth gliding motion. However, when inflamed, the iliotibial band does not glide easily. When inflamed, there is pain with motion of the knee. Usually the pain worsens with continued movement. Usually, the pain goes away with rest.

This problem usually arises when there is a sudden increase in sports activities involving the lower extremities (your legs). Runners, soccer players and basketball players are examples of activities causing this. Others who are prone to ITBS include individuals with mechanical problems such as leg length differences, abnormality of walking, bowed legs etc. This diagnosis (learning what is wrong) is made by examination. X-rays are usually normal if only soft tissue inflammation is present.

Treatment of ITBS begins with proper footwear, icing the area of pain, stretching, and resting for a period of time. Incorporating low-impact cross-training activities may also help. Your caregiver may prescribe anti-inflammatory medications as well.

Incorporating low-impact cross-training activities may also help. Your caregiver may prescribe anti-inflammatory medications as well.

Home Care Instructions

  • Apply ice to the sore area for 10 to 20 minutes, 3 to 4 times per day. Put the ice in a plastic bag and place a towel between the bag of ice and your skin
  • Limit excessive training or eliminate training until pain goes away
  • While pain is present, you may use a gentle range of motion. Do not resume use until instructed by your caregiver. Begin use gradually. Do not increase use to the point of pain. If pain does develop, decrease use and continue the above measures. Gradually increase activities that do not cause discomfort. Do this until you finally achieve normal use
  • Perform low impact activities while pain is present. Wear proper footwear
  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver

Seek Medical Care If

  • Your pain increases or pain is not controlled with medications
  • You develop new, unexplained symptoms (problems), or an increase of the symptoms that brought you to your caregiver

For more information about iliotibial band syndrome of the thigh, please call (918) 494-AOOK (2665).

IT band can be a pain in the leg

Speaking of Health

Topics in this Post

  • Sports Medicine

The iliotibial, or IT, band is a long fibrous band of fascia tissue that runs from the outside of your hip down to the outside of your knee. It has a complex job description: it helps lift your leg to the front and to the side of your body, and it supports your knee during flexion and extension. So when this hardworking tissue is injured or overworked, it can be a real pain in the leg.

Repetitive motion, like running, rowing or cycling, typically is the culprit in IT band issues. The IT band also is irritated when exercising on uneven surfaces, like trails or hiking downhill. The first warning sign of injury usually is pain on the outside of your knee, at the hip or down the side of your leg. You may notice the pain right after an exercise class or run. IT band problems can be experienced by active adults, children, and student and adult competitive athletes.

Take it easy

The key is to keep a small problem small. Don’t ignore the pain and try to push through it. Instead, take a rest from the activity you were doing for a few days. If the pain persists, see a sports medicine specialist or athletic trainer, who often will prescribe physical therapy.

Do physical therapy

The physical therapist will develop a series of exercises for you that will treat your whole leg, including targeting and strengthening your core and larger gluteal muscles to relieve some of the IT band’s workload. The therapist also may do some soft-tissue work or dry needling.

Other treatments may include steroid injections or, in rare cases, surgery.

Avoid injury

People whose leg and core muscles are weaker may be predisposed to IT band injuries.

Weakness can be diagnosed with a simple test:

  • Do a single-leg squat.
  • If your knee tips in as you bend down, rather than pointing forward, be proactive and consider leg-strengthening exercises.

Students involved with youth sports typically are screened, and any concerns are identified before they begin the activity. Not catching issues before the activity may result in injury midseason with athletes having to take time away from their sport while they go through rehabilitation.

In general, the best way to avoid having your IT band become a pain the leg, is to maintain your core, leg and gluteal muscle strength.

Jacob Erickson, D.O. is a physician in Sports Medicine in Onalaska, Wisconsin.

Topics in this Post

  • Sports Medicine

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Nikita Yushchenko (author)

MUSCLES OF THE LOWER LIMB – abducting the hip

The muscles that abduct the thigh cross the hip joint and are located on its lateral side. They are attached mainly to the greater trochanter.

Hip abductors include :

  1. gluteus medius;
  2. gluteus minimus;
  3. pear-shaped;
  4. obturator internal;
  5. twin;
  6. tensor fascia lata (see hip flexors).

1. Gluteus medius partially covered by the gluteus maximus. It starts from the outer surface of the ilium and the broad fascia of the thigh, and is attached to the greater trochanter.

Gluteus medius :

  • Abducts the thigh.
  • Also, due to the fact that the anterior fibers of the muscle go from top to bottom and back, and the posterior ones – from top to bottom and forward, it takes part in both pronation and supination of the thigh.

2. Gluteus minimus is located under the gluteus medius. It starts from the ilium and is attached to the greater trochanter.

Gluteus minor :

  • Abducts the hip.

3. Piriformis originates on the anterior surface of the sacrum, passes through the greater ischial foramen into the gluteal region, and inserts at the apex of the greater trochanter.

Piriformis muscle :

  • Abducts the thigh.
  • Supinates the thigh.

4. The obturator internus muscle is located inside the small pelvis. It starts from the obturator membrane, goes to the lateral side, bends through the lesser sciatic notch, enters the gluteal region and attaches to the trochanteric fossa.

5. Upper and lower twin muscles , lying above and below it, are attached to the tendon of the obturator internus muscle as it leaves the small pelvis. These two small muscles originate from the ischial spine (upper muscle) and the ischial tuberosity (lower muscle).

  • The function of the obturator internus and gemelli muscles is to abduct the hip if the pelvis is fixed, and in a standing position on one leg – to keep the pelvis from tilting towards the opposite leg.
  • In addition, these muscles are also involved in the supination of the thigh.

The main role in hip abduction is played by the gluteus medius muscle, and its anterior and middle sections perform abduction to a greater extent than the posterior one. With distal support, the gluteus medius and minimus tilt the pelvis to the side.

In the first case, the gluteus medius muscle loses in strength, but has a gain in the variety of movements, in the second – a gain in strength with a small range of motion in the joint. This is due to the different ratio of the arm of the muscle force and the arm of gravity. With proximal support, when the pelvic bones are fixed and the muscle acts on the thigh, the arm of its force is small, while the arm of the resistance force, and, consequently, the moment of force (weight of the lower limb) are significant. It takes a lot of strength to complete this movement. With distal support, when the lower limb is fixed (standing on one leg), the arm of the muscle force is greater than the arm of gravity. In this regard, the muscle is able to show significant force, holding the weight of the opposite half of the body and preventing the pelvis from tilting towards the non-supporting leg.


  • Human Anatomy (with the basics of dynamic and sports morphology): A textbook for institutes of physical culture. – Ed. 14th. / Under. ed. B. A. Nikityuk, A. A. Gladysheva, V. F. Sudzilovsky. – M.: Sport, 2018. – 624 p., ill.


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Nikita Yushchenko (author)


Muscles that cross the hip joint take part in hip extension. These muscles go both from the pelvis to the thigh, and from the pelvis to the lower leg.

Hip extension

Muscles that produce hip extension in the hip joint include :

  1. gluteus maximus;
  2. biceps femoris;
  3. semitendinosus;
  4. semimembranous;
  5. large drive.

1. The gluteus maximus is located on the back of the hip joint. In humans, this muscle is well developed, as it holds the body in a vertical position with its tension.

Gluteus maximus :

  • Extends and supinates the thigh.
  • With a fixed hip, extends the pelvis in relation to the hip.

2. The biceps femoris is located on the outside of the back of the thigh. There are two heads in the muscle – long and short.

Biceps femoris :

  • Extends the thigh when the pelvis is fixed.
  • With a fixed thigh, flexes and supinates the lower leg.

3. Semitendinosus is located on the back of the thigh on the inside.

Semitendinosus muscle :

  • Extends the thigh and flexes the lower leg
  • As the lower leg flexes, it participates in its pronation.

4. Semimembranosus starts on the ischial tuberosity. Located behind the semitendinosus muscle, it attaches to the medial condyle of the tibia.

Semimembranosus :

  • Extends the thigh and flexes the lower leg.
  • As the lower leg flexes, it participates in its pronation.
  • When the lower leg is fixed, the semimembranosus muscle tilts the pelvis back and also fixes it to the thigh, preventing forward tilt.

  • The long head of the biceps femoris, semitendinosus and semimembranosus are biarticular muscles. They can produce hip extension with the lower leg fixed in the knee joint.