Iio-tibial band syndrome (ITBS)


ITBS is a common injury experienced by those who partake in activities that require repetitive knee bending, particularly in endurance events. This injury is characterised by pain on the outside of the knee, often described as sharp and/or burning in nature. Aggravating activities often include running downhill or descending stairs.


There continues to be controversy as to the true mechanism of injury. Historically, it was hypothesised the ITB was rubbing on the outside of the knee joint, but extensive studies have shown this could be unlikely due to the true anatomy of the ITB itself. The ITB has three layers which are continuous with surround soft tissues and have firm attachments onto the Femur (thigh bone). However, there are thoughts that an underlying soft tissue structure (bursa) forms and becomes inflamed and painful. Studies have been performed where patients with ITBS actually have an intact, non-inflammatory ITB.


Conservative treatment is often advised primarily, consisting of rest, pain relief, stretching, strength training and running habit modification. Evidence does not suggest one specific approach to be favourable, revealing more research is needed. One study revealed 44% of patients returned to sport fully at eight weeks, and 91.7% returned fully at six months.


Further research is needed to explore the true pathophysiology of the injury, as well as which conservative interventions are most effective in returning those to sport and exercise.