When IT Band Syndrome Isn't IT Band Syndrome: Here's What Else It Could Be

If you’ve ever run or jumped and noticed a sharp pain at the outside of your knee, you may have looked online and thought it was related to your iliotibial (IT) band. People call it iliotibial band syndrome (ITBS), and it relates to inflammation that occurs from the friction of the IT band against the bone it interfaces with as the knee repetitively bends and straightens.

But if you (or your physical therapist) looked at the mechanics of your movement and it looks fine, and your hip muscles on the affected side are strong, and massaging out the outside of your quadriceps, your hamstrings, and your tensor fascia latae (TFL) doesn’t help, then the piece you might be missing could be the proximal tibiofibular joint. More specifically, maybe your fibular head is not moving how it should.

What causes the fibular head to not function as it should? It could be through trauma like jumping or landing wrong off of a step, or it could be from repetitive rotational sports (like from many high-intensity pickleball games). While the exact cause of it may be hard to decipher without a thorough history and questions about the events leading up to the symptoms, what you do about it will be pretty similar. 

There’s a way to “reset” how the fibular head moves at the joint. The joint moves in different directions, and it may be easier to visualize how it should move with the motion of your knee in this video:

Conceptually, you want to stabilize the fibular head as you move your knee in the directions that typically give you issues. In other words, you can use your fingers or the base of your hand to hold the fibular head in place as you move your knee. As you perform this, the motion should start to free up.

Hopefully, this exercise helps. Remember, we heal smarter, not harder.

When do you typically experience outer knee pain?

• 0%While running
• 0%While jumping
• 0%During sports (e.g., pickleball, basketball)
• 0%Going up/down stairs