ITB Friction Syndrome

Let’s continue our knee pain series, and talk next about ITB Friction Syndrome.

So far we have covered, most likely, the most prominent source of knee pain in Patellofemoral Joint Pain Syndrome. The link can be found here:

You can also download our FREE E-Book, ‘Your Comprehensive Guide to Fixing Runner’s Knee’ at the following link:



ITB Friction Syndrome (ITBFS) is an overuse injury that presents with outer knee pain that is then exacerbated by sporting activity. It is common amongst runners, cyclists and endurance athletes.

This pain is most commonly described as an ache around the outer knee and typically comes on at the same point during each run or cycle. For example, it is common for athletes to state that they get this pain every run at the 10km mark, or every cycle after 30-minutes.

ITBFS, ITB Friction Syndrome, Illiotibial Band

Why does it occur?

The ITB is a thickening of the fascia that forms along the outer thigh. It receives muscular attachments from the hip muscles (significantly the TFL muscle and the gluteus maximus), and inserts into the bone just below the knee joint.

As the muscles around the hip and outer quadriceps get tight, they can increase tension of the ITB and therefore compression around the outer knee. This compression irritates structures around this area and results in pain.



The underlying principle for the treatment of this condition is this- ‘the ITB is NOT a muscle!’ Tightness along the ITB is most commonly caused from tightness through the TFL and gluteus maximus. Therefore, treatment usually begins here. Your physiotherapist can assess tightness through these areas and give you targeted treatment advice.

To release your glutes, use a spikey ball or foam roller. Find your trigger point and apply pressure to the area for 30-seconds until you start to feel this muscle release or the pain of the trigger point starts to dissipate. Repeat for 4-5 trigger points in the area and perform 2x/daily.

Foam Roller Glutes, Foam Rolling, Glute ReleaseTo release your TFL, use a foam roller.  Similarly, roll this muscle for 2-minutes, 2x/daily.

TFL release, foam rolling

It is also important to ask the question ‘why’ your hip muscles may be getting tight. Tightness through your TFL, gluteal muscles and therefore your ITB is usually resultant from weakness through your gluteal muscles- especially the gluteus medius muscle. Other factors that play a role include overworn footwear and foot posture issues.

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