Iliotibial band syndrome is a fibrous band that spans over outer aspect of the thigh to insert over leg bone around knee joint.

Athletes requiring repetitive bending of the knee joint are prone to develop ITB friction syndrome. Repetitive strains of ITB due to flexion and extension of the knee (repetitive movements of the knee) causes compression effect on connective tissues deep to the ITB to produce pain on the outer side of the knee. It is a common cause of knee pain on the outer aspect in runners and cyclist. Tight iliotibial band and weak hip muscles may predispose to ITBFS. Patients with ITB syndrome, complains of lateral knee pain during running and other sports activity. Tenderness can be elicited proximal to outer joint line.

Noble compression test is specific to Iliotibial band friction syndrome. In this test patient is made supine with knee bent to 90 degrees. Now examiner compresses over knee joint proximal to joint line and patient is asked to straighten the knee and hip slowly. In ITBFS, this maneuver will produce pain.

Treatment is mostly conservative with NSAIDS, Ice application and ITB stretching exercises. Local steroid injection may help in non-responders. Surgical resection of posterior half of ITB is required in resistant cases.

These 2 exercises described below can be done at home. Repeat ten times and do twice a day.

• Sit on the floor as shown in the picture and pull your knee which is paining. This will stretch your ITB. Hold for 10 seconds and repeat for 10 times. Do it twice a day.

• Take support of a wall and stretch your leg which is paining as shown in the picture. Hold for 10 seconds then relax. Repeat for 10 times and do it twice a day.