Andries Lodder biokineticist in Fourways
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Iliotibial Band Friction Syndrome (ITBFS)

Posted on January 16th, 2013 by Andries Lodder


Do you have pain at the outer side of the knee or thigh?

You could have ITB friction syndrome.

This condition is exacerbated by sporting activity and is commonly seen in runners, cyclists and endurance athletes.

What is the ITB?

The iliotibial band is a thickening of the fascia and connective tissue that envelops the whole thigh.  It extends from the gluteus maximus muscle and a muscle called the tensor fascia lata, down towards the femur, tibia and fibula bones i.e. around the outer side of the knee. Its function is to provide lateral (outer) stability between the knee and the hip.

What causes ITB friction syndrome?

If the muscles around the hip are tight, this can cause compression further down around the lateral femoral condyle, thus causing pain at the outer side of the knee. Altered biomechanics and muscle imbalances play a role in ITBFS. It often arises in runners and cyclists with weakness of their hip abductors and overworked hip adductors. These imbalances place compressive loads through the ITB, causing irritation and pain. The pain occurs at around the same time/distance during activity. Longer training sessions, downhill running and running on cambered courses often aggravate the symptoms. 

Treatment of ITB friction syndrome

One can use ice, anti-inflammatories and corticosteroid injections for acute pain. Physiotherapy is largely beneficial in the treatment of ITBFS. We use different modalities, including massage, myofascial release, dry needling, electrotherapy and various taping techniques to reduce muscle tension, tone and pain in the ITB. One can stretch the ITB, however studies have shown that the ITB has the strength of soft steel, thus merely stretching it is not very advantageous. What is more useful  is strengthening the hip abductors and external rotators (pelvic stabilizers) to address underlying weaknesses. Teaching one to self-massage over the foam roller is also helpful.

merryn manley 

If you have more queries about ITB pain give Merryn a call on 0836954794 or email her at

Link to her Webpage:


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