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ITB Syndrome: A Perspective from Sports Physio

Writer's picture: Caryn von FintelCaryn von Fintel

Updated: Jun 11, 2024

Knee Pain Cased by

Iliotibial Band Syndrome (ITBS), sounds sinister, but is a common injury affecting runners and cyclists. The injury can also impact anyone who engages in activities that require repetitive knee flexion and extension, like, hockey, swimming, hiking, tennis, basketball and even dancing, especially among young athletes.


As a physiotherapist, understanding the intricacies of this condition is crucial for providing effective treatment and helping patients return to their activities pain-free.


So let’s dive into the anatomy, causes, symptoms, and physiotherapeutic management of ITB Syndrome.


Anatomy of the Iliotibial Band

Anatomy of the Iliotibial Band

The iliotibial band (ITB) is a thick, fibrous band of connective tissue that runs along the outside of the thigh, extending from the hip to the shin. It originates from the tensor fasciae latae (TFL) muscle and the gluteus maximus, then travels down the lateral side of the thigh to insert on the lateral condyle of the tibia. The ITB plays a crucial role in stabilizing the knee during activities such as running, walking, and cycling.


Causes of ITB Syndrome


ITB Syndrome occurs when the ITB becomes tight or inflamed, leading to friction as it rubs against the lateral femoral epicondyle during knee movement. Several factors can contribute to this condition, including overuse, biomechanical issues, muscle weakness or imbalance or muscle tightness and from increasing their training load too quickly.


Symptoms of ITB Syndrome

Symptoms of ITB Syndrome

The hallmark symptom of ITB Syndrome is lateral knee pain, typically felt on the outside of the knee. This pain often worsens with activities involving knee flexion and extension, such as running or cycling.


Patients may also experience a snapping sensation, tenderness, swelling and pain over the outside of the knee.


Physiotherapeutic Management of ITB Syndrome


Effective management of ITB Syndrome involves a comprehensive approach addressing both the symptoms and underlying causes. Key components of physiotherapy for ITB Syndrome:

  • Assessment and diagnosis

  • Pain management

  • Manual therapy to release tightness

  • Stretching and then strengthening areas that are weak to prevent it from occurring

  • Biomechanical correction including gait analysis

  • Footwear assessment, with referral for orthotics if needed

Physio Management of ITB Syndrome

Sports Physio Conclusion


Iliotibial Band Syndrome is a common yet manageable condition that can significantly impact an individual’s ability to participate in physical activities. As physiotherapists, sports physio, our role is to provide a comprehensive and individualized approach to treatment that not only alleviates symptoms but also addresses the underlying causes. By combining pain management, stretching, strengthening, biomechanical correction, and patient education, we can help patients recover from ITB Syndrome and return to their active lifestyles.





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