ITB SYNDROME: Why, What and How to Get Relief

What Is ITB Syndrome?

ITB Syndrome (AKA Iliotibial Band Friction Syndrome) is an overuse injury, and is one of the most common causes of “Runner’s Knee”.

The ITB is a band of fascia which runs the length of the outside of the thigh. It originates from the TFL and Gluteus Maximus muscles near the hip, and attaches at the tibia and femoral condyle at the outside of the knee. When the knee is bent at approximately 30°, which is often  the angle of a runner’s foot when it strikes the ground, pressure is placed on the irritable bony structures that lie at the outside of the knee beneath the ITB, causing inflammation and discomfort.

By Healthimage [CC BY-SA 4.0], via Wikimedia Commons / Cropped from original.

Causes of ITB Syndrome

  • Incorrect running technique (poor biomechanics)
  • Weakness and/or instability around the hips, core and quadriceps
  • Weak foot arch
  • Over training or sudden increase in training
  • Excessive downhill training
  • Unsuitable footwear
  • Endurance running

Symptoms of ITB Syndrome

  • Sharp or burning pain at outside of knee that sometimes radiates up the outside of the thigh
  • Swelling over the outside of the knee
  • Pain during early knee bending
  • Generally worsens with activity such as running

Treatment for ITB Syndrome

ITB Syndrome usually responds well to conservative treatment, and involves the following:

  • Begin with correct analysis of exactly what’s causing the irritation
  • De-load ITB (rest)
  • Myofascial release around legs and hips
  • Strengthen hip, knee and leg muscles
  • Normalise hip, knee and foot mechanics
  • Integrate strength, balance and agility exercises
  • Correct running technique

A common myths about ITB Syndrome treatment is the notion that foam rolling the ITB directly will ‘stretch’ or ‘lengthen’ the tightened fascia. Through rigorous scientific research, we now know that fascia itself is an extremely durable material, and does not respond in this manner. The changes that occur due to foam rolling his area are more to do with the response of the quads. o roll away, but focus on the quads.

Further relevant resources:

Knee Pain article.