Iliotibial band syndrome

Iliotibial band syndrome

The iliotibial band (ITB) runs along the outside of the leg. It is a thick band of connective tissue known as fascia. It starts from around the hip and continues to the top of the outer knee. Many people will complain of tightness along the ITB, particularly runners, gym goers and sports players.

Iliotibial band syndrome (ITBS) describes the condition where the ITB becomes irritated and inflamed. It is also called runners knee at times, ITB syndrome or iliotibial band friction syndrome.


Causes of ITBS vary from individual to individual and include:

  • Leg length difference.
  • Weak hip muscle.
  • Poor foot biomechanics (e.g. rolls in or flattens).
  • Poor balance and coordination.
  • Poor strength and control of the legs.
  • Running on hills.
  • Overtraining.


Pain around the outside of the knee is the most common symptom. It is typically brought on by walking or running. Runners generally say that the start of the run feels good but pain increases with continued running. If inflamed there may be associated swelling on the outer knee.


There are various treatment options for ITBS.

  • Anti-inflammatory medications prescribed by a GP or sports physician.
  • Rest is important in the initial phase of treatment, this does not mean absolute rest, but relative rest from activities that are known to irritate the knee such as running.
  • Stretching and strengthening exercises – A sports chiropractor or physiotherapist will advise you on specific exercises that you can do.
  • Foam roller exercises can be effective to help loosen the muscles that surround the ITB.
  • Sports massage can be useful.
  • Electrotherapy to help reduce pain and inflammation, your sports chiropractor or physiotherapist may use electrotherapeutic treatment techniques, including ultrasound.
  • Dry-needling techniques or acupuncture may be useful. A professional or therapist inserts needles into specific parts of the body. Acupuncture or dry-needling can be beneficial in reducing pain only.
  • Load management advice is very important. A trained sports chiropractor or sports physiotherapist should be consulted for this.

For more information please book a consultation with one of our sports chiropractors.