Common Conditions

Iliotibial Band (ITB) Syndrome

Symptoms, Common Causes and Treatments

What is Iliotibial Band (ITB) Syndrome?

The ITB Syndrome describes a pain on the anterolateral aspect of the knee, which is very common among long distance runners and hikers.

What is the Iliotibial Band?

The Iliotibial band is a broad band of fibrous tissue located on the lateral side of the thigh, extending from the pelvis to the lateral knee, which is mainly used for energy storage and release during exercise. The ITB is connected to the Tensor fascia lata (TFL) and Gluteus maximus muscles. When the knee is repetitively moving back and forth in about 30 degrees of flexion under load, there could be excessive pressure built up on the lateral knee near the ITB attachment, causing pain and discomfort.

Symptoms of ITB Syndrome

Localised pain on the anterolateral side of the knee
Increased pain when landing, going downstairs, or running downhill
Gradual onset of pain

Causes of ITB Syndrome

Load Changes

Sudden increase in training volume, in terms of speed or distance, or changes in terrain such as inclines or hardness of the running surfaces, may increase the pressure on the knee from the ITB;

Running Technique

Studies have found that over-striding or a narrow stride width may increase the pressure of the ITB at the knee, resulting in discomfort;

Inadequate Strength of Gluteus Medius

Inadequate strength of the gluteus medius may increase the load on the TFL, which indirectly increases the pressure of the ITB on the knee during exercise.

Managing and Treating ITB

Professional Treatments

Running assessment & modifications: Running techniques will be thoroughly assessed for problems such as over-striding or narrow stride width with proper adjustments;
Manual Therapy: soft tissue massage could be performed to tight muscles like the quadriceps, gluteus maximus or tensor fascia lata to relieve tension around the knee;
Electrophysical modalities: adjunct treatments such as ultrasound therapy, laser therapy, shockwave therapy might be incorporated to relieve pain;
Exercise therapy: Strength training for the gluteus medius, or other key muscle groups in the kinetic chain.

Frequently Asked Questions

Is foam rolling useful for relieving ITB pain?

No. Studies have shown that the fascial tissues of the ITB are very resilient and the pressure of a roller does not have much stretching effect on them. On the contrary, since the gluteus maximus and the tensor fascia lata muscles directly attach to the ITB, foam rolling those muscles might be more beneficial for pain relief.

Is ITB Syndrome the same as Runner's Knee?

No, it is not. The pain of runner’s knee is mostly in the front of knee, while the pain of ITB syndrome is more on the lateral side.

If I have ITB Syndrome, should I stop training immediately?

The ITB Syndrome is an overuse injury, which is directly related to the training load. As a result, pain relief can be better achieved with rehabilitation exercises and adjustments in training load or running techniques after examination. Sudden cessation in sporting activities may cause the strength or fitness to deteriorate, which predisposes the athletes to further issues when returning to sports.

Testimonials & Reviews

I had never been a believer in physio therapy in the past or that my experience with multiple chain medical physiotherapy center had brought me nothing but temporary improvements. Until I had came across mobilize physiotherapy where they take the extra mile to examine your situation and tailor a physiotherapy session. The physiotherapists at Mobilize not only identifies the root cause and provide massages for pain relievers but also to provide take home exercises for improvements. I was never rush out the door for the next session and they ensure that I had receive the right treatment before the session ends.
I would highly recommend this physiotherapy center.

Edmond Chan

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I came to them with chronic neck and knee issues, and they didn't just provide massage therapy. They took the time to thoroughly evaluate the source of my problems and develop a comprehensive treatment plan.
Through a combination of targeted hands-on therapy, customized strengthening exercises, and patient education, they helped me regain mobility and address the root causes of my pain. I learned the correct ways to strengthen the muscles and improve my posture to prevent future issues.
The staff is incredibly knowledgeable, taking the time to explain everything and ensure I understood how to continue my progress at home. Thanks to their expertise and dedication, I'm now pain-free and able to return to my regular activities without any limitations.

Arthur Liu

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After suffering years of chronic knee issues after ACL reconstructive surgery I was recommended to this clinic and the results were amazing. The centre does not only focus on pain relief but with an extremely holistic approach, assesses the root cause of pain and focuses on return to sports and performance once the pain diminishes. Most physiotherapy centres in Hong Kong do not even offer this level of attention to detail and service and would highly recommend to anyone having chronic pains or want to have proper post orthopaedic surgery rehabilitation!

Arnold Woo

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Very professional therapy that doesn't only focus on passive treatment but also targets training of weak spots to improve overall performance and physiological sustainability.

Felix Lo

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Will was very professional. He was very thorough with the assessment and suggested different exercises for me to improve my condition. Recommended 👍🏾

Keith So

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I can't recommend my physio partner enough! They are always patient and provide valuable guidance to help me relieve chronic pain and improve my performance in jiu-jitsu. Their expertise has been invaluable to me. Highly recommended!

Felix Kung

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