Knee Pain Series-Part 1: Iliotibial Band Syndrome

One of the most common causes of knee pain in runners is Iliotibial Band Syndrome or, more commonly (and easier to say!), runner’s knee or IT band syndrome.  For the purposes of this post,  I’ll refer to it as ITBS from here on in.

The Iliotibial band is a sheath of connective tissue which runs from the iliac crest (top of the hip) and attaches to the outside of the tibia (shin bone).  When the knee is flexed, the band ‘flicks’ over the lateral epicondyle of the femur (the bony part on the outside of the knee).  ITBS occurs when excessive friction over the femoral epicondyle causes inflammation of the iliotibial band, hence why it is often seen in runners.


  • Pain on the outside of the knee, or around the epicondyle of the femur
  • Pain within the knee
  • Tightness of the iliotibial band
  • Pain worseneing when running
  • Pain on running downhill or climbing stairs
  • Pain on the epicondyle at around 30 degrees flexion when pressed and the leg is flexed and extended


  • Frequent hill running
  • Weak hip muscles
  • A natural tightness of the iliotibial band
  • Excessive foot pronation
  • Discrepancy in leg-length


  • Sports massage is highly effective in the treatment of ITBS to ease tighness
  • Pain-causing activities should be avoided
  • Orthotics to place in the shoes can help with over-pronation
  • Use of ice or cold therapy after activity
  • Stretching can help (see below) but is often not as effective as the above treatments

ITB stretch

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One Response to Knee Pain Series-Part 1: Iliotibial Band Syndrome

  1. Pingback: I did it! | Back Pain and Beyond

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