Iliotibial Band Friction Syndrome (ITBFS)

The Iliotibial band (ITB) is a fibrous band extending from the hip to the outside of the knee. It is involved in stabilising the hip and knee, particularly in activities such as running.

ITBFS occurs due to friction between the ITB and the lateral femoral epicondyle. Pain usually comes on from long distance running, especially when running down hills or stairs. Onset can be sudden or come on gradually over time.

Patients generally report a localised pain on the outside of their knee, which is tender to palpate. Pain is aggravated by repetitive bending of the knee and walking downstairs. Patients will normally have a tight ITB and lateral quads. Other possible causes of developing ITBFS are:

• Weak hip stabilising muscles and poor core stabiliy
• Poor foot biomechanics e.g overpronation
• Leg length difference
• Tight muscles such as hamstrings, calves, gluteals, quadriceps and hip flexors
• Overtraining
• Incorrect footwear

Initially patients should ice the tender area and stop the aggravating activity. It may also be necessary to take anti-inflammatories. It is important to have this condition treated as soon as possible as it can take a long time to settle if the above causes are not addressed, meaning a prolonged period of rest from running.

Treatment typically will consist of soft tissue massage of the ITB and associated muscles, dry needling plus and prescription of appropriate stretches and strengthening exercises. It is useful to purchase a muscle release roller to self massage your ITB as necessary and prevent reoccurrence. Referral to a podiatrist for a biomechanical assessment is also recommended, especially if running is your main form of exercise.

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