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ITB Syndrome running injuries

Iliotibial Band Syndrome: what to do

ITB Syndrome (Iliotibial friction syndrome) is one of the most common causes of “Runner’s Knee” and can account for up to 22% of overuse injuries in runners. Being an overuse injury, it is caused by repeated trauma rather than a specific incident.

What is the Iliotibial Band ?

The ITB, or iliotibial band, is a long, thin band of connective tissue that runs down parallel to your femur (thigh bone) on the outside of your thigh. At the top of your thigh it is attached to your Tensor Fascia Latae (TFL) muscle, and Gluteus Maximus. At the bottom it attaches to your shin and on lower outside portion of the thigh bone.

What happens with your ITB

Iliotibial Band slides forwards and backwards across a bony point just above the knee with movement. This repetitive sliding can create excess friction, especially when the knee is bent at 30 degrees, which commonly happens just as your foot strikes the ground in running. When you have an irritated the ITB you might feel like somebody is stabbing you in the side of the knee when you run, especially running downhill.
Pain is felt at the end of the IT band where it attaches on the outside of the knee.

Unfortunately this painful injury can quickly become crippling

Symptoms of ITB Syndrome

  • Pain is a sharp point on the outside of the knee, or (rarely) as sharp pain on the lateral side of the hip.
  • Pain worsens with continuance of running or other repetitive activities, not upon first step.
  • Swelling over the outside of the knee.
  • Pain during early knee bending 
  • Gradual onset of symptoms which if they
  • Pain generally goes away after ceasing activity, it often comes back when running is resumed.
  • Common in new runners, or increase in mileage or hill running.

Some Causes of ITB Syndrome

  • Poor biomechanics (running technique); particularly inwards rolling knees and hips
  • Endurance running (training for ½. and full marathons, ultra-marathons)
  • Weak hip and buttocks muscles and hip rotators =  excessive lateral shifting of the pelvis
  • Weak core muscles
  • Poor foot arch control /fatigue – ankles or knees collapse inwards, increasing tension on
  • Worn out or unsuitable runners
  • Sudden increase in mileage for training
  • Excessive hill training (particularly downhill)
  • Always running on the same side of the road, around same loop / track in same direction
  • Running at angles or being uneven
  • Over-pronation, leg-length discrepancy

Some Tips

  • ITBS challenging to treat
  • Icing, Foam roller / Massage
  • Glute and hip strengthening
  • Mobilisation of tight structures, break up scar tissue and restore normal function
  • Strengthening and stretching exercises for hip abductors, core and glutes
  • Avoid downhill running, ease off on the volume and intensity of training


  • Strengthening the glutes and hips
  • Maintaining good soft tissue mobility
  • Regular stretching, massage, foam rolling
  • Monitor training volume, intensity, downhill
  • Run on different sides of the road/switch sides of the track
  • Mix up running surfaces softer trails/dirt/grass
  • Advice about orthotics if needed

So don’t wait or run in pain. Call today to book an appointment