ITB syndrome explained

Written by willem van der Meijden | 05/03/2016

WP Physio | Painful ITB

What is ITB?
IT Band Syndrome is an overuse injury. It is commonly found in both runners and cyclists. The pain most often occurs on the outside of the knee and is very painful. The pain ‘switches’ on and makes running impossible. The pain results from the IT band rubbing against the lateral epicondyle of the knee.


The letters, ‘ITB’ stand for iliotibial band. There are a number of causes of ITB issues.

What causes ITB?
1. Overuse.ITB very often comes along as a result of ramping mileage up too quickly. There are normally other factors that make an athlete susceptible to ITB but a sudden increase of mileage and speed will bring the injury on.

2. Tight Muscles.

Tight muscles will certainly be a factor. We use the Thomas test to ascertain the tightness of the iliopsoas muscle group. Tight Glutes, Hamstrings and Quads will also contribute.

3. Myofascial Adhesions.

In my experience, many suffering from ITB have adhesions between the band and the Vastus Lateralis muscle that lies beneath it. These can be released using soft tissue massage techniques.

4. Weak Hip Muscles.

One of the runners gait signs that we look for when people are on the treadmill, is weakness in the Glut Medius muscles. This shows up as the hip falling down as the runner goes through his/her gait. This hip weakness will cause the IT band to both tighten over the hip and will also place pressure on the lateral side of the knee.

5. Incorrect Running Shoes.

Running shoes that either allow for too much pronation or running shoes that overly correct the foot can play a role in ITB. We place runners on the treadmill and measure their rate of pronation via camera and computer. We are then able to prescribe the correct pair of running shoes.

6. Poor Running Form.

Make sure that you do not overstride. The straighter your leg upon landing the more the band will scrape against the lateral epicondyle of the knee. We are able to analyze your running gait via both video and computer measurements.

7. Running on heavily Cambered Roads.

South African runners very often get ITB on their right hand knees. This comes from running on the right hand side of the road so as to face oncoming traffic. The road camber places undue strees on the outside of the right hand knee.

For the best treatment of ITB Syndrome, contact your nearest Physiotherapists!