‘ITBS’ or Iliotibial Band Syndrome is described as a severe sharp or stabbing pain on the outside of the knee; worst at about 30 degrees of knee flexion.
It was first thought that ITB syndrome was aggravated in sportsmen by the flexion and extension of the knee during downhill running, or in cycling, especially when the saddle was too high. It was proposed that this repetitive bending of the knee caused excessive friction between the iliotibial tract and the lateral femoral epicondyle on the outside of the knee, inflaming the tract. Cycling is very repetitive; during 1 hour of cycling, a rider may average up to 7,200 pedal revolutions. The smallest amount of misalignment, whether anatomic or equipment related, can lead to dysfunction, impaired performance, and pain.