ITB Friction Syndrome (Lateral Knee Pain)

12 October, 2014

What is ITB friction syndrome?

By Lauren Harms

The iliotibial band (ITB) is a thick band of fibrous tissue which begins at the pelvis and runs down the outside of the thigh where it attaches into the shin bone (tibia) and also partly into the side of the knee cap (patella). The ITB acts to stabilise the knee and to move the hip sideways.

Iliotibial band friction syndrome describes pain caused by inflammation of this band as it passes bony prominences of the knee joint.

As the knee bends, the band must pass across bony projections, and with repetitive movement friction can occur at this point during walking or running.  This then results in pain and inflammation on the outside of the knee.  If symptoms are ignored, more inflammation and possible scarring may occur, causing increased pain.

ITB friction syndrome is more common in runners, particularly with running at slower speed or downhill runners as this tends to increase the contact of the ITB with the bony prominence of the thigh bone. In contrast, sprinting and fast running tends to increase the knee flexion angle, so is less likely to cause ITB friction.  It can also be quite common in cyclists.

What causes ITB friction syndrome?

  • Leg length difference
  • Knocked knee posture
  • Excessive or prolonged pronation of the foot (rolling in of the foot)
  • Hip muscle weakness (particularly gluteals)
  • Muscle tightness (especially of hip flexors and gluteals) can lead to increased pressure on the ITB

How should ITB friction syndrome be treated?

  • Physiotherapy: You should consult your physiotherapist as soon as possible to have your knee pain thoroughly assessed to confirm diagnosis and to work out what factors have contributed to your pain so that these issues can be addressed. Your physiotherapist will also start hands on treatment for your pain, such as soft tissue release or dry needling. A home exercise program will be devised to get your symptoms under control and to get you back to your normal exercise program as soon as possible.
  • Ice: Ice wrapped in a wet cloth should be applied for 10-15 minutes 1-3 times per day or when the knee is sore.
  • Roller: A foam  roller is an extremely useful form of self-massage, which helps to increase the length of the ITB.
  • Activity modification: It is very important that you cease the painful activity; otherwise you will exacerbate the inflammation and prolong your injury.

How long should recovery from ITB friction syndrome take?

Time to recovery from ITB friction syndrome is variable; it depends on how much inflammation has been caused in the ITB and how long the symptoms have been there. With rest and appropriate (timely) treatment usually symptoms will resolve within 4-8 weeks. So don’t hold off any longer, give us a call at Encara so we can help get you back up and running!


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