The IT band (iliotibial band) is a thick band of fibers that runs the length of the outside of the hip and thigh—from the pelvis all the way down to the tibia (shinbone) just below the knee. Sometimes irritation and snapping can occur where this structure passes over a boney prominence known as the greater trochanter. This irritation is called bursitis and often occurs naturally as we get older. In athletes long episodes of training without rest or a proper stretching regimen can also cause bursitis and a tight IT band resulting in iliotibial band syndrome.
When patients present with IT band syndrome and/or greater trochanter bursitis, Dr. Anz will first recommend a trial of non-operative measures. This includes a period of rest, eliminating any activity that may flare the symptoms (e.g. running long distances), and methods aimed to decrease inflammation at the location. Physical therapy is often helpful to guide patients on methods to decrease the tension on the IT band as well as to help strengthen the adjacent musculature and core.
Surgery is treat IT band tension and bursitis is rarely necessary, and in some instances it may not be helpful. The rare instance where surgery is necessary is in cases of external snapping hip syndrome which does not respond to non-operative measures. Dr. Anz ultilizes an endoscopic technique to approach surgical cases of external snapping hip syndrome. First, he will perform an iliotibial band release (known as a fasciotomy). Using an arthroscope in an endoscopic fashion, Dr. Anz will get a visual of the IT band and will perform a small release in the fascia. He makes this release at the area of maximum tightness by cutting a diamond shape release at the area of the greater trochanter. The goal is to prevent further snapping sensations. This limited release also slightly lengthens the entire IT band. A second step is a trochanteric bursectomy. This involves the removal of inflamed bursal sac and irritated tissue.
Following surgery to treat IT band tightness, patients can be weight bearing as tolerated as long as an additional tendon repair has not been performed. Dr. Anz will prescribe a rehabilitation program that will focus on strengthening of core musculature and hip stabilizers in addition to continued IT band stretching.
For more information on IT band tightness, or to schedule a consultation to learn more about arthroscopic hip surgery, fasciotomy, or iliotibial band release, please contact the Gulf Breeze, Florida orthopedic surgeon, Dr. Adam Anz located at the Andrews Institute.