IT Band Syndrome Diagnosis

A doctor can usually diagnose IT band syndrome after a patient interview and physical examination. 

Physical Exam

During an exam, a doctor will press on different parts of the knee to see if the pressure causes pain. The doctor may also ask the patient to perform various movements, such as standing on one leg or squatting. The Ober test is the most common physical test given to patients with suspected IT band pain. 

The Ober test

During this test, the patient lies on his or her side, with the affected side facing up and knees slightly bent. The doctor will use one hand to keep the patient’s pelvis steady while supporting and guiding the affected leg backward, towards the patient’s rear. The doctor will then gently drop the affected leg down towards the exam table. How flexible the leg is during this test offers clues as to whether the patient has a tight IT band.

Patient Interview

A doctor will ask a patient about the onset of his or her knee symptoms, the pattern of pain, how symptoms affect lifestyle, as well as what makes the pain better or worse. A patient’s reported symptoms are important for diagnosis and treatment.

Medical Imaging

Diagnosing iliotibial band syndrome does not usually require medical imaging.¹Hutchinson LA, Lichtwark GA, Willy RW, Kelly LA. The Iliotibial Band: A Complex Structure with Versatile Functions. Sports Med. 2022;52(5):995-1008. doi:10.1007/s40279-021-01634-3 While the injured area of the IT band may be thicker than normal,²Agridag Ucpinar B, Bankaoglu M, Eren OT, Erturk SM. Measurement of iliotibial band diameter in iliotibial band friction syndrome and comparison with an asymptomatic population. Acta Radiol. 2021;62(9):1188-1192.  doi:10.1177/0284185120958407 the difference is too small to help in diagnosis. 

Medical imaging, such as an MRI or ultrasound, might be ordered if¹Hutchinson LA, Lichtwark GA, Willy RW, Kelly LA. The Iliotibial Band: A Complex Structure with Versatile Functions. Sports Med. 2022;52(5):995-1008. doi:10.1007/s40279-021-01634-3^,3Pegrum J, Self A, Hall N. Iliotibial band syndrome. BMJ. 2019;364:l980. doi:10.1136/bmj.l980^,4Jiménez Díaz F, Gitto S, Sconfienza LM, Draghi F. Ultrasound of iliotibial band syndrome. J Ultrasound. 2020;23(3):379-385. doi:10.1007/s40477-020-00478-3:

• The knee pain has lasted several months, despite rest and other treatments
• Iliotibial band syndrome was successful treated in the same knee once before, but the pain came back
• The doctor wants to rule out other knee problems, such as a torn meniscus or stress fracture. 

Other medical conditions that can have similar symptoms to IT band syndrome include:

• A meniscus tear
• Knee osteoarthritis
• A ligament sprain
• Stress fracture
• Patellofemoral stress syndrome
• Bicep femoris tendinopathy

The bicep femoris is a small, deep hamstring muscle that travels down the back and side of the thigh, and its tendon attaches at the outside of the knee. Chronic overuse can cause this tendon to become injured and painful.