Dealing with ITB syndrome

For runners and walkers, pain around the knee can be incredibly uncomfortable and put a hold on training plans. We’ve covered some of the issues already so this time we’re looking at the catchily named iliotibial band friction syndrome.

So what exactly is it and why do so many people have problems with it?med0508x

As this diagram shows, the iliotibial band (ITB) is essentially a strong band of fibres that run from the outer surface of the pelvic bone down to the top of the shin.


It’s there to ensure good muscle function and provide stability for the knee – particularly when walking or running. As you bend and then straighten the leg, the band moves forward and backwards over bulbous part on the outside of the femur – as shown in this picture.


On this outer part there is a bursa – essentially a tiny little water balloon. These can be found in many different parts of the body and they sit between bones and soft tissue to prevent tendons rubbing on the bone.

However, problems can occur when the tendon rubs too much over a bursa, causing it to become inflamed – this is known as bursitis.

What’s the answer?

First the inflammation needs to settle which can be helped by relieving some of the tension over the bursa. This can be achieved by rest and massage – though this may involve a bit of discomfort on a foam roller. It’s difficult to stretch the ITB itself but you stretch the muscles that insert into it.

Acupuncture can also be effective in these early stages to help settle the symptoms.

Once the symptoms have settled it’s important to identify why the problem occurred in the first place. This could be down to reduced ‘control’ – where muscles are too weak or are not working properly or at the right time – commonly the muscles involved are at the hip.

We would usually suggest some functional strengthening exercises such as a single leg squat or weight shifting squat. single leg squat and weight-shifting squat.

Another cause can be increasing mileage too quickly when running – so take time to assess any training plans or exercise patterns. It’s not exclusively running though – it can happen as a result of cycling as well.

The good news is that if you do get an ITB issue it’s nothing to worry about. It’s a common problem though many people simply manage the issue rather than finding out the underlying cause. At Physio Central we’ll work with you to not just solve the symptoms, but find out the cause as well.


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