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 requires the patient to lie on his or her side, with the affected side facing up. The doctor supports and guides the affected leg backwards, towards the patient’s rear, and gently drops it down towards the table. How pliable the leg is during this test may offer 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. The doctor may recommend detailed imaging, such as an MRI, to rule out other problems, though this is not usually necessary.

During diagnosis the doctor will want to rule out other medical conditions that can have similar symptoms to IT band syndrome, such as 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.

Other conditions to be ruled out include knee osteoarthritis, a ligament sprain, meniscal tear, stress fracture, and patellofemoral stress syndrome. Some patients may even have referred knee pain caused by lower back problems. 1 Khaund R, Flynn SH. Iliotibial band syndrome: a common source of knee pain. Am Fam Physician. 2005 Apr 15;71(8):1545-50. Review. PubMed PMID: 15864895.

Dr. Christian Foglar is an orthopedic surgeon specializing in sports medicine and trauma and reconstructive surgery. He practices at Advanced Orthopaedics in San Jose, CA, and is a lieutenant colonel in the U.S. Army Reserves.