ITB Friction Syndrome

ITB Friction Syndrome

ITB Friction Syndrome

What is ITB Friction Syndrome

ITB Syndrome (Iliotibial band syndrome) is one of the most common causes of “runner’s knee” pain. It is an overuse injury that presents with pain and/or tenderness on a structure that is outside the knee called the Lateral Condyle of Tibia. The Iliotibial band is a dense fibrous connective tissue or fascia that runs down the outer thigh from the hip (the Ilium) to the knee. ITB’s main function is in knee flexion, extension and stabilisation of the knee as well as hip abduction (to stop the hip and knee from buckling in).


Overuse of ITB is often caused by repetitive knee flexion and extension movements commonly seen in cyclists, runners and stair climbers. This repetitive action can cause excessive friction due to the ITB rubbing on the knee bone that it is attached to or runs on top of. Whilst ITB is not a muscle itself, there are other muscles which are attached to it such as the Tensor Fascia Latae (TFL) and the lower fibres of the Gluteus Maximus. Consequently, any weakness and/or tightness of the hip muscles, TFL or Gluteus Maximus can lead to poor biomechanics which puts a lot of stress on the ITB.

Causes of ITBS Friction:

  • Poor training technique
  • Increasing distances run or cycling too quickly
  • Shoe or orthotic issues
  • Hip flexor imbalance
  • Structural abnormalities
  • Muscular imbalances


  • Dull aching or burning sensation on the outside of the knee during movements especially when walking up stairs
  • Pain starts as an awareness of slight, minor or dull pain which progressively worsens


  • Activity modification to prevent further aggravation of pain
  • Myotherapy treatment to address the soft tissue structures and to reset the firing pattern of the muscles in the hip to better stabilize the hip and the knee.
  • Corrective Exercise to strengthen and stretch the surrounding structures.

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