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Iliotibial Band Syndrome (ITBS)

Updated: Aug 14, 2023

Iliotibial band syndrome (ITBS) is often described as a pain and discomfort along the outside of the thigh and knee. It is a very common overuse syndrome frequently associated with activities that require repetitive knee flexion and extension such as long distance running, biking, circuit training, skiing, dancing, jumping sports...the list goes on!

woman working out in gym doing side lunge

Although the aforementioned activities make us prone to developing ITB Syndrome, a stressed and angry Iliotibial Band will not hesitate to make itself known even if in the absence of said sports.


The Iliotibial Band is a fascial band that originates from the Tensor Fascia Latae muscle (TFL), attaches high on your pelvic bone (the Ilium), runs down the side of the thigh and attaches to the side of the knee/lower leg (the Tibia).

Can you see from this depiction, the reason why your symptoms are distributed in that seemingly strange pattern?

graphic of anatomy of iliotibial band syndrome

Common symptoms

  • Pain (maybe burning) when applying pressure to the side of your knee.

  • Lateral hip or knee pain may worsen when running or walking down stairs.

  • Possibly a slight snapping sensation on the outside of the knee when bending it

  • Symptoms worsen with increased activity.

Why is this happening to me?

There are many other factors surrounding ITB syndrome, including strength and flexibility of the surrounding thigh and hip muscles, core stability influencing body mechanics, the type of shoes you’re wearing or even training on a slanted terrain could all be playing a role in your current situation. Let’s look at some of these factors briefly;

  • Weak glutes; weakness in your gluteal muscles can lead to changes in your body mechanics during movement, such as the way your feet hit the floor as you run (excessive pronation), the way your knees align when supporting your weight (increased valgus) both of which when occurring repetitively will cause friction to the IT Band which inserts on the outside of your knee.

  • Weak core; weakness in your core can cause poor control of your pelvis and hips, which translates down the chain into faulty mechanics like the ones described above.

graphic of strong glutes verses weak glutes
Weak glutes contribute to an unstable pelvis, which will directly impact the chain below when you walk/run.


What can physical therapy do for me?

Physical therapists are trained to observe and assess how your musculoskeletal system is working. We look at the way you run, walk, squat, step up onto a platform etc. looking for the minutiae of your mechanics. We perform strength and balance tests to assess how those things are contributing to the workings of your system. We will identify areas of pain, tenderness, tightness in your body. We gather this information so as to devise a plan that addresses your problematic areas in order to restore and improve mechanics and function, thereby helping you reach your personal goals.

A general treatment map for ITB Syndrome includes:

  • Hip/core strengthening: Strengthening weak muscles of the hip, pelvis and core will allow for the stability needed for better lower extremity mechanics.

  • Stretching: ITB flexibility and health can be positively influenced by keeping hip muscles that attach to it lengthened.

  • Foam rolling: Another effective tool to maintain ITB flexibility and health!

  • Body Mechanics: Re-educating your awareness through exercise to maintain alignment and use effective body mechanics will translate to the activities you love such as dancing, running, biking and is an integral part of your rehabilitation process.

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