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Run Well! - Iliotibial Band Syndrome (Runners knee)

We are excited to kick off a new series in partnership with Sports Injury Clinic.  www.sportsinjuryclinic.net   This site has been a well used site for me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don't have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.


Run well logo The Iliotibial band is a thick band of fascia which runs from the outer hip, down the outside of the thigh, and attaches on the outside lower part of the knee. At the top of this band, is the small muscle known as Tensor Fascia Latae, which attaches the fascia to the iliac crest (pelvis).

As the ITB passes over the lateral epicondyle of the femur (bony bit on the outside of the knee) it is prone to friction. This friction is at its worst when the knee is bent at an angle of approximately 20-30 degrees. This is the approximate angle of the knee at foot strike when running. Think of it as a tight rubber band flicking back and forwards over the bone. This repetitive friction results in the pain and inflammation associated with runners knee.

Causative factors, which can lead to the development of IT band syndrome (Picture: Copyright Peter Gardiner for www.sportsinjuryclinic.net), include:Itband picture

Ø      A tight or naturally wide IT band

Ø      Trigger points within the IT band and gluteal muscles

Ø      Overpronation

Ø      Overuse (i.e. too much too soon)

Ø      Excessive hill running

Ø      Running on a cambered surface (where one side is lower than the other)

Ø      Leg length discrepancy

Ø      Weak hip muscles.

Symptoms include:

Ø      Pain on the outside of the knee

Ø      Tightness in the iliotibial band

Ø      Pain is often made worse by running downhill

Ø       Bending and straightening the knee whilst applying pressure to the IT band attachment on the outside is often painful


What treatments can be used?

There is no substitute for professional treatment, however, in mild cases, and certainly in an attempt to prevent IT band syndrome, self-treatment can be effective.

Ø      Rest – rest from any aggravating activities; don’t attempt to run on, as it will only get worse!

Ø      Ice – applying ice to the area on the outside of the knee will help to decrease pain and inflammation

Ø      Stretch – Once it is pain-free to do so, start to stretch the muscles of the leg, paying particular attention to the IT band itself.

Ø      Strengthen the muscles on the outside of the hip such as gluteus medius

Ø      Correct any biomechanical abnormalities or training errors

Stretching the IT band can be tricky. The easiest method we have found is as follows:

Ø      Stand leaning forwards, with your hands on a table for balance.

Ø      To stretch the right leg, take the right foot behind the left and as far to the left as possible, keeping the knee straight.

Ø      Push the hips out to the right to increase the stretch.

Ø      Hold this position for 30 seconds.

To strengthen Gluteus Medius, the side-lying clam is the best exercise:

Ø      Lay on your side with the side you want to work on top.

Ø      Have the knees bent and together and feet together, in line with the spine.

Ø      Make sure your hips are stacked one on top of the other.

Ø      Lift the top knee away from the bottom one, keeping the feet together.

Ø      Ensure you keep your back straight and still throughout.

Ø      It may only be a small movement initially but should increase as your strength improves.

Ø      Start off performing 2 sets of 10 reps and gradually build to 3 sets of 20!

If you were to visit a professional sports injury therapist, other treatments may include sports massage, acupuncture, electrotherapy such as ultrasound and a full rehabilitation programme.

Persistent cases can be treated with a corticosteroid injection, although this should be a last resort, after consistent and thorough conservative treatment has failed.

For more information on Iliotibial band syndrome (runners knee) including a rehabilitation programme, exercise pictures and videos as well as massage demonstrations, please visit:


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Marion Hauser - Caring Medical Prolotherapy

Educational article! It's great for runners to have a better understanding of the various injuries that can result from their favorite pastime. But as you say, self-treatment is no substitute for professional care. The number and complexity of the issues reinforces how difficult it is to self-diagnose. Best advice, as you mention, is to pay attention to preventing injury wherever possible.

Stacey Mcbride

Hmm… It's not good to experience Iliotibal Band Friction Syndrome or IBFS especially if you love sports and any outdoor activities. Maybe, proper diet may help avoid the disease. Massage has been used for recovering injuries, especially those caused by accidents. It may also help improve your muscles and relieve pain from IBFS. Right?

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Thanks for the write up! This is really some great stuff here! Wishing for a following post for the similar subject.

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This sounds like one fun race. Can't wait to check out the pictures. Good luck Amy and Tom!

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