Iliotibial Band Syndrome


Iliotibial Band Syndrome is one of the leading causes of lateral knee pain in runners. The iliotibial band is a thick band of fibrous tissue on the outside of the thigh, extending from the outside of the pelvis, over the hip and knee, and inserting just below the knee. The band is crucial to stabilizing the knee during running, moving from behind the femur to the front of it during the gait cycle. The continual rubbing of the band over the end of the femur, combined with the repeated flexion and extension of the knee during running may cause the area to become inflamed and irritated.


The symptoms range from a stinging sensation just above the knee joint on the outside of the knee or along the entire length of the iliotibial band to swelling at the point where the band moves over the femur. The pain may not occur immediately, but may worsen during activity and persist afterward. A single workout of excessive distance or a rapid increase in weekly mileage can aggravate the condition.

Causes of Injury

Factors like old shoes, running on cambered road surfaces, and tight turns on indoor tracks have all been proposed as risk factors for ITBS but none of these have much scientific evidence to back them up.  A host of studies have connected hip abductor and external rotator muscle weakness with ITBS so those are the chief things to target.

Short Term Treatment

  • Decrease mileage or cease activity.
  • Ice knee after activity.
  • ITB strap worn just above the knee.

Long Term Treatment

  • Light stretching and a thorough warm-up before running. Stretch again afterwards.
  • Strengthening exercises for the gluteus medius, hip abductors, and external rotator muscles can help support the leg thus lessening the load on the ITB.
  • Massage and rolling along the length of the ITB have long been advocated for ITBS but the ITB is very stiff and hard to stretch. Most stretches that target the ITB stretch it very little if any. You can target the muscles that attach to the ITB, mainly the gluteus maximus and tensor fasciae latae.


Since ITBS is the result of a biomechanical problem your ability to return to running will be determined by your progress in hip strength. Strengthen your hips and your ITB will thank you!

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