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Ilio Tibial Band (ITB) Friction Syndrome

Alice Baquie

Alice Baquie

· 3 min read

The fibrous band of tissue called the Ilio Tibial Band (ITB) runs from the lateral hip along the outside of your quad and attaches below the knee. ITB Syndrome is common in distance runners form the recreational to elite level & is an overload or overuse injury which causes pain, swelling and dysfunction.

An increase of training in a short timeframe, change in terrain or increase in the intensity of training can lead to ITB Syndrome. Muscle imbalances such as deep core and glute weakness can also contribute to lateral chain overload & cause pain, swelling and lateral knee friction at the distal (lower) insertion of the fascial band.


Generally the first symptom is a sharp pain on the lateral (outside) side of your knee. In some cases the pain travels up to your hip. You'll find that the pain increases when climbing stairs or running or jogging - especially down hill. The pain is most intense at the start of your flexing of the knee and can often feel sore, stiff and inflamed when sitting for prolonged periods of time.

Generally the pain will start slowly and build up the more you raise the regularity or intensity of your training/running and is exacerbated by running up hill and walking up and down stairs.


Rest will ease the symptoms quickly. Tape and braces can provide some short term relief of symptoms, however to solve the problem you'll need to focus on particular exercises to strengthen your glute and correct your running gait.

PILATES FOR RUNNERS! A low impact, run specific strength regime that will help correct imbalances but also not inflame the ITB further.


The following table outlines some key symptoms to look out for in common knee injuries. This table is not a replacement for seeking a professional diagnosis but may help you to identify issues for further research.

My best advice is to seek professional help from a doctor or physiotherapist if you are experiencing any of the following symptoms to correctly diagnose your issue and develop a plan for treatment.

REFERENCES: Mucha MD, Caldwell W, Schlueter EL, Walters C, Hassen A, Hip abductor strength and lower extremity running related injury in distance runners: A systematic review., Journal of Science Medicine in Sports, 2017;20(4):349-355 .Falvey, E., Clark, R., Franklyn‐Miller, A., Bryant, A., Briggs, C., & Mccrory, P. (n.d.). Iliotibial band syndrome: an examination of the evidence behind a number of treatment options. Scandinavian Journal of Medicine & Science in Sports, 20(4), 580–587.

Alice Baquie

About Alice Baquie

Alice has been a physio for fourteen years and specialises in injury prevention and management for runners. Alice has represented Australia in distance running and gymnastics so has sound knowledge of athletic performance and understands the importance of strength conditioning and mobility to help keep the body moving effectively to mitigate injuries.

Alice, otherwise known to her wonderful pilates community as AB is a fun loving inclusive person always ready to chat and have a laugh and has hosted 1000’s of online classes which attract people from all around the world, including 25 Aussie Olympians.