The Iliotibial band (IT band) is a strong structure of fascia that extends from the hip to the knee on the outside of the thigh. Iliotibial band syndrome is a overuse injury that is prevalent among runners and cyclist, which results to pain and swelling on the lateral aspect of the knee. The initial management for IT band syndrome involves conservative measures, but in some cases, procedures such as IT band release or lengthening may be recommended.

Conservative Treatments

1.     Rest and Activity Modification: Avoiding or changing activities that exacerbate the IT band can lessen inflammation and pain.

2.     Physical Therapy: Flexibility and strengthening activities especially the hip abductor and the external rotator muscles may help in increasing flexibility and decrease tension on the IT band.

3.     Foam Rolling: Foam rolling the IT band can be effective in reducing tension in the area if done on a consistent basis.

4.     Anti-inflammatory Medications: Pain and inflammation can be managed with non-steroidal anti-inflammatory drugs (NSAIDs).

5.     Corticosteroid Injections: In certain instances, the doctor may decide to inject the affected area with a corticosteroid to help decrease inflammation.

Iliotibial band release or lengthening

If conservative measures are unable to provide adequate relief of symptoms, surgical procedures such as IT band release or lengthening may be employed. These procedures are meant to relax the muscles and relieve pain.

1.     IT Band Release: This is done by making small cuts on the IT band to free it from tightness and minimize rubbing on the lateral femoral epicondyle which is the bony lump at the side of the knee.

2.     IT Band Lengthening: In this procedure, a part of the IT band is stretched to relieve stress. It includes cutting of the IT band in the form of Z shaped incisions after which the tissue is stretched.

Post-Surgical Recovery

Recovery from IT band release or lengthening typically involves:Recovery from IT band release or lengthening typically involves:

1.     Physical Therapy: Physical therapy after surgery involves activities that help in regaining strength and flexibility to facilitate proper healing and movement.

2.     Gradual Return to Activity: Most of the time, patients are told to slowly go back to their daily routines depending on the pain they feel and the instructions from their doctors.

3.     Monitoring and Follow-up: Subsequent check-ups to assess the healing and recovery process.

Risks and Considerations

Like any other surgery, there are risks involved in IT band release or lengthening which include infection, scarring and inadequate pain relief. Consequently, these procedures are usually carried out only when the more conventional procedures have not delivered the desired results.


IT band release or lengthening may be helpful for patients with chronic IT band syndrome who have not benefited from other forms of management. However, there are certain risks and recovery time that comes with the procedure and therefore it is advisable to try other non-surgical methods first and if one decides to undergo surgery, it is advisable to consult with a physician regarding the surgery.