Iliotibial Band Syndrome (ITBS)

Iliotibial Band (ITB) Syndrome is one of the most common knee injuries amongst runners, weight lifters & cyclists. The ITB is a large thick band of connective tissue (fascia) that runs down the lateral surface of the thigh. It has an important function when it comes to providing stability in the hip as well as the knee. It originates from the tensor fascia late and the gluteus medius. It inserts on the lateral condyle of the tibia.

Cause of ITBS:

ITBS comes from when there is constant friction between the ITB and the lateral epicondyle of the femur. It is a common overuse injury which results in pain being felt in the lateral aspect of the knee which will be tightened when the knee is flexed to 30 degrees.

There is normally a fluid filled sac known as a bursa which normally assists with the ITB gliding smoothly over the knee when you bend and straighten your leg. The problem arises when your ITB is too tight, and friction is then caused when you bend your knees.

As mentioned above, people that are most likely to get ITBS if runner, cyclists and weight lifters due to the repetitive nature that arises from the bending of the knee.

There are certain factors that will increase your odds of developing ITBS:

Using the wrong training techniques:

1. Not incorporating enough stretching, warm up or cool down in your exercise program
2. Overtraining – pushing too far or too long too soon
3. Neglecting recovery time between workouts
4. Wearing wrong or worn out shoes
5. Running downhill
6. Only running on the one side of the road
7. Training on a banked surface rather than a flat surface

Physical factors:

1. Bowed Legs
2. Arthritis (particularly in the knee)
3. Leg length discrepency
4. Rotating foot/ankle/Leg inwards when running
5. Weakness of Glueus, Core of Hip Flexor Muscles

Symptoms of ITBS:

Main symptoms for ITBS will be pain on the lateral side of the knee, just above the knee joint. In the early stages of ITBS the pain will go away as you warm up, yet as it progresses pain may get worse as you exercise.

Other symptoms may include:

1. Aching, burning or tenderness on the lateral side of the knee
2. Click, pop, or snap feeling on the lateral side of the knee
3. Pain up and down the leg
4. Warmth & redness on the outside of the knee

A Dr or your fellow biokineticits will be able to tell you have ITBS based your symptoms, history and a physical exam. Yet there are other causes of lateral knee pain and an x-ray may be required to rule out any other potential problems.


ITBS can be treated without surgical intervention, yet it is important to treat it properly so that you avoid it from recurring. Usually it should take between 4 – 6 weeks for a full recovery and return to normal activities.

Initial treatment should be to try and relieve the pain. This will involve avoiding any activity that will trigger or cause pain, take over the counter non-steroidal anti-inflammatory drugs as well as ice the site of pain for 10 to 15 minutes at a time.

Your biokineticist can assist you with your return to normal pain free activity. In your initial consultation your biokineticist will do a physical exam to assess the cause of the ITBS and from their develop a specific program to help speed up your recovery process. They will be able to assist you with the right tips to warm up and cool down, help you choose the correct footwear which will suit your gait needs, look to adjust your training routine. An exercise program will be put together to suit your individual requirements, in this program your biokineticist will help improve your strength imbalances and assist you with the specific stretches required to help treat your ITBS. Once you are ready to return to sport it is important to move onto a maintenance program so that this condition doesn’t return.

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