Iliotibial Band Friction Syndrome

30 December 2021

Tell any long-distance runner or cyclist about your stinging pain at the side of the knee or hip; you will get a knowing sympathetic look.

Iliotibial band friction syndrome is one of the commonest complaints amongst runners, cyclists and intense court sports.

Iliotibial Band Friction Syndrome
ITB Syndrome

Iliotibial band friction syndrome gets its name from the iliotibial band (ITB) rubbing against a bony protrusion at the side of your knee. The ITB is a continuation of one of the largest hip muscles.

It spans as a thick band of tissue on the outside of the thigh. Starting from the pelvis, it runs over the side of the hip and ends just below the knee. Just before it crosses the knee, it runs over a protrusion in the thigh bone (lateral femoral epicondyle).

Therefore, the frequent rubbing over this bony protrusion from bending and straightening of the knee irritates the band. This causes inflammation. The tighter the ITB, the harder it rubs over the protrusion.

What Tightens The Iliotibial Band?

Three basic things tighten the iliotibial band.

  1. Training methods
  2. Biomechanical gait issues
  3. Weak outer thigh muscles

Training Methods

Running on banked surfaces, inadequate warm-up or cool down, overly fast increases in distance or excessive downhill running are faults associated with running.

They can strain the iliotibial band.  In cycling having the feet toed inwards commonly causes the band to get tight.

Biomechanical Gait

Problems with foot structures such as high or low arches and uneven leg length typically tighten the iliotibial band on one side.

A complete biomechanical assessment helps determine the faults. Where appropriate, foot orthotics can correct these problems.

Weak Outer Hip Muscles

Weak outer hip muscles force the iliotibial band (ITB) to work harder to compensate and becomes tight as a result. Exercise to strengthen the outer hip muscles helps to lighten the load on the ITB.

Despite avoiding all the three issues mentioned, athletes with a high training volume often still experience painful ITBs. In such cases, deep tissue massage will help release the tight band.

Don’t forget to stretch the ITB. Ignoring them can lead to groin pain and low back pains. Or watch the video below on the use of a foam roller.