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Running Injuries: ITB Syndrome

Running Injuries:ITB syndrome

When runners start getting pain in the outside knee, they may be experiencing a tight iliotibial band (ITB) that is pulling at the knee. Iliotibial band is a band of connective tissue that originates in a muscle in the hip (tensor fasciae latae) and extends downwards over the lateral quadriceps muscles and attaches to the tibia (lower leg). When the knee is flexed less than 30 degrees, the ITB helps extend (straighten) the knee joint. However, when the knee is flexed greater than 30 degrees, the ITB helps to further flex the knee.

With repetitive motions like running, the ITB is constantly being pulled by tensor fasciae latae, and there is a constant rotation motion where it helps the knee flex and extend. This repetition can lead to friction between the band and the bones at the knee, causing irritation and inflammation in the area. As a result, bursitis (inflammation of a bursa – sac of fluid to prevent friction between bones/muscles/tendons) or ITB syndrome (irritation of the ITB itself) can develop. Diagnostic ultrasound can differentiate between the two conditions. However, treatments for both are similar, as they share a common cause.

Treatments for ITB syndrome may include soft tissue therapy to release muscles in the hip and knee, manual therapy to correct mechanics of the lower body, and exercises that include a strengthening/stretching regime to rebalance the muscles. Modalities may also be used to reduce pain and inflammation. Use of ice or muscle creams (Biofreeze, Motion Medicine) may help to temporarily alleviate the pain.

If you are experiencing knee pain and think you may have ITB syndrome, it’s important to stop all painful activities and book an appointment with one of our rehab specialist to complete a full assessment, and provide you with an individualised treatment program.


Written by: Danette Lam, MScPT