What is an ITB syndrome?

Your iliotibial band is a long thin band of fascia which runs down the outside of your thigh. It spans from the top of your hip and goes down to the side of your knee.

The iliotibial band friction syndrome (ITB syndrome) refers to an issue that often occurs to long-distance runners and walkers, where band inflames due to repetitive friction of the tendon band against your thigh bone (femur).

How commonly does ITB syndrome occur?

ITB syndrome is one of the most common causes of "Runner's Knee" and can account for up to 22% of overuse injuries in runners. It is also a common presentation in exercising adults, occurring in up to 15% of women and 7% of men (Falvey, et al. 2010)

 It is caused by repeated use and pressure rather than a specific incident.

What causes the repetitive friction of the iliotibial band?

The repetitive friction of the ITB is precipitated by poor running biomechanics and underlying muscular imbalances. Fatigue of your side-gluteal muscle forces your ITB to compensate during running, thus increases pressure put through the side of your knee.

The most common muscle imbalances are from:

• Weak hip/gluteal stabilises

• Weak hip rotators

• Weak inner quadriceps

• Weak core muscles

• Poor foot arch control

Other factors that can lead to poor running form:

• Training in worn-out or unsuitable running shoes

• A sudden increase in training

• Excessive hill walking/running (especially downhill)

• Poor running technique

You might feel these symptoms:

• Sharp or burning pain just above the outer part of the knee

• Pain over the pathway of the outer leg

• Pain over the front and outside of the knee or thigh.

• Pain that worsens with the continuance of running or other repetitive activities

Physios can do to help with treatment:

Good news! It is definitely treatable and on average takes 2-4 weeks to see a significant improvement! Our treatment involves:

• First determine the cause: imbalance of muscles, weakness, or running technique

• Reduce acute pain with soft tissue and joint mobilisations

• Modify your current exercise program to fix the imbalances

• Create an exercise program to reduce the risk of re-injury

What you can do for yourself?

You can self release your ITB using a form roller.

Roll up to your hip and down to your knee approx. x5 times

With your hands and legs supported on the ground like shown in the picture to ensure that only part of your body weight goes onto that form roller. Be gentle to start off with as it can be quite tender to do this.

Reference and evidence

Falvey, E., Clark,R., Franklyn‐Miller, A., Bryant, A., Briggs, C.,& McCrory, P. (2010). Iliotibial band syndrome: An examination of theevidence behind a number of treatment options. Scandinavian Journal ofMedicine & Science in Sports,20(4), 580-587.

Lavine R.Iliotibial band friction syndrome. Current Reviews in Musculoskeletal Medicine,2010; 3(1-4) :18–22

SchwellnusMP, Theunissen L, Noakes TD, Reinach SG. Anti-inflammatory andcombined anti-inflammatory/analgesic medication in the early management ofiliotibial band friction syndrome: A clinical trial. South-Africa MedicineJournal, 1991;79(10):602-6.