ITB Syndrome

Question 1

What is ITBS?

Answer 1

A common overuse injury affecting the lateral aspect of the knee, characterised by inflammation of the ITB.

Question 2

What is the ITB?

Answer 2

A thick band of fascia which runs laterally down the thigh to the anterolateral knee.

Question 3

What population is ITB syndrome especially prevalent in?

Answer 3

Runners, with an estimated incidence up to 15%.

Question 4

What is the clinical presentation of ITBS?

Answer 4

Sharp pain laterally, potentially radiating to outer thigh or calf.
Exacerbated by heel strikes (running, descending stairs).
Potentially audible snapping sensation and swelling

Question 5

What ‘special tests’ can be done to diagnose ITBS?

Answer 5

Renne Test
Noble’s Test
Ober’s Test

Question 6

What is Renne Test?

Answer 6

Patient stands on the affected leg and flexes other to 90*, can use wall for balance. Then perform a slow single leg squat.
+ve = pain onset.

Question 7

What is Noble’s Test?

Answer 7

Patient supine lying, grasp the ankle and slowly bend knee back and forth several times. Then apply firm pressure on the lateral epicondyle.
+ve = pain or snapping / crepitus

Question 8

What is Ober’s Test?

Answer 8

Side lying, Passively extend and abduct hip joint then slowly lower towards table.
+ve = knee pain or leg remains in abducted position.

Question 9

What is the management of ITBS?

Answer 9

Activity modification, Rest and NSAIDs.
Then exercise - stretch what is tight and strengthen what is weak.

Question 10

Give some examples of good exercises for ITBS:

Answer 10

Bridging with Band
Side Lying Abduction
Crab Walk Bands
Side Plank