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Ilio-tibial band syndrome

Iliotibial Band Syndrome (ITBS) is a common overuse injury that affects many athletes, especially runners and cyclists. It is a painful condition caused by inflammation and irritation of a fat pad or a bursa that has been antagonised by the iliotibial band, a thick band of connective tissue that runs along the outside of the thigh, from the hip to the knee.

As I am currently experiencing this injury, I would like to offer my knowledge and approaches to resolving the issue.


ITBS is primarily caused by repetitive friction and stress on a fat pad or bursa deep to the iliotibial band insertion. The condition often arises due to certain biomechanical factors, such as:

  1. Overpronation: Excessive inward rolling of the foot during running or walking can increase stress on the iliotibial band.

  2. Muscular imbalances: Weak hip abductor and gluteal muscles can lead to increased stress on the iliotibial band.

  3. Training errors: Suddenly increasing mileage, intensity, or frequency of workouts without proper conditioning can contribute to ITBS.

  4. Improper footwear: Worn-out or ill-fitting shoes can affect the alignment of the lower extremities and contribute to ITBS.


The most common symptom of ITBS is pain on the outer side of the knee, which can radiate up to the hip or down to the shin. The pain is often sharp and worsens with activity, especially when the knee is bent at a 30-degree angle. Other symptoms may include:

  1. Swelling or thickening of the iliotibial band.

  2. Tenderness along the outer knee.

  3. Clicking or popping sensations during movement.

  4. Gradual onset of symptoms during exercise, which may progress if left untreated.


Fortunately, ITBS can be effectively treated with a combination of conservative measures. Here are some common treatments for ITBS:

  1. Rest and activity modification: Avoid activities that exacerbate the pain and allow the body time to heal. Modify your training routine to reduce stress on the iliotibial band.

  2. Ice therapy: Apply ice to the affected area for 15-20 minutes every few hours to reduce inflammation and alleviate pain.

  3. Stretching and strengthening exercises: Perform specific stretches and exercises to address muscle imbalances and improve hip and gluteal muscle strength.

  4. Physical therapy: Seek guidance from a physical therapist who can design a personalised treatment plan involving targeted exercises and manual therapy techniques.

  5. Anti-inflammatory medication: Non-steroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and reduce inflammation. Consult with a healthcare professional before taking any medication.

  6. Corrective footwear and orthotics: Ensure you have proper footwear that provides adequate support and cushioning. In some cases, orthotic inserts may be beneficial in correcting foot mechanics.

  7. Gradual return to activity: Once the pain subsides, gradually return to your regular activities while monitoring any signs of discomfort.


Preventing ITBS is key to maintaining an active lifestyle. Here are some preventive measures to consider:

  1. Incorporate proper warm-up and cool-down routines before and after exercise.

  2. Gradually increase the intensity and duration of your workouts.

  3. Wear appropriate footwear that provides proper support and cushioning.

  4. Cross-train to maintain overall muscle balance and reduce repetitive stress on the iliotibial band.

  5. Regularly stretch and strengthen the hip and gluteal muscles.


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