ITB Syndrome ~ Your Knee Is Not Injured!


ITB Syndrome ~ Your Knee Is Not Injured!

ITB PainIncident: Woman mid thirties runs 4 miles through park.  Slows down and comes to a slow walk and even a hobble.  She reports a burning sensation just to the outside of her knee.  Painful to run on.  Painful to step down stairs.  Walking can even be bothersome.  Woman claims she has a bad knee.  She doesn’t yet realize that it’s not a knee injury, but instead it is the oh so common ITB Syndrome.

Her running career is over and it barely even started.  Over time this pain pattern continues and woman is tempted to give up on her running routine.  The pain hijacks her fitness enthusiasm and brainwashes her to think that she must settle for gentle restorative yoga for the rest of her life.  Oh Great! and just as she was beginning to get back into it with gusto!              


Aint no injury gonna get in this ladies way. Proceed with wisdom and caution…Find out what’s really going on!

Common Victim: Long Distance Runner, Tennis Players & Cyclists though not limited to these activities.

Suspect:  Bad knee.

Main Perpetrator:  ITB ~ Iliotibial band.

ITB Syndrome often gets overlooked as all attention goes directly to Runner’s knee.

Iliotibial bandProfile of ITB Syndrome:

The ITB is not a bad guy, but so many of my clients & even myself are quick to blame it for our tight backs & sore knees.  Of course it’s great to recognize a “bad knee” isn’t really a bad knee, but rather a tight & inflamed IT Band or even weak quad muscles or a hip misalignment.  So what is one to do once they know it’s not the knee, but it’s ITB Syndrome? I’ll get to that in a minute.  But first, what is the ITB?

The ITB is a long thick band of fibers that attach to the iliac crest (the border of the pelvic bone that we usually think of as the part of this hip bones that stick out in thinner body types).  This band of fibers runs down the outside of the leg and attaches to the tibia (shin bone).


ITB Syndrome

ITB Syndrome is often described as pain at and near the lateral portion of the knee.  ITB syndrome is caused by inflammation of the Iliotibial Band where it crosses this lateral portion of the knee.  Repetitive motion can cause this.

The ITB crosses at the lateral condyle of the femur bone (thigh bone).  When you flex your knee such as in running, squatting, cycling or hiking the ITB fibers move across this condyle .  There is a bursa at this point and if that is irritated or inflamed then it makes it very difficult for the Iliotibial Band to glide over it freely. Or the opposite, if the ITB is irritated then repetitive motion can thus lead to an inflamed bursa and the cycle continues.

Major knee pain is the result of this inflammation around this lateral portion of the knee joint.  It is not to be mistaken as a knee injury though! Don’t give up on your running or sport just yet! This is not to say that ITB syndrome can NOT turn into a knee injury.  The Iliotibial band is designed to help stabilize the knee and if there is an issue with the ITB then possible knee injury could follow, so do your research, exercising, stretching & resting.

What are some other factors that can contribute to ITB SYNDROME?

  • Weak quad muscles
  • Weak abductor muscles
  • Anatomical abnormality
  • Excessive lower leg rotation from over pronating
  • Uneven leg length
  • Tilted Pelvis
  • Muscular imbalance
  • Running on a banked surface
  • Inadequate warming up / cooling down
  • Running up / down stairs

 What are some Treatments for ITB Syndrome?

R.I.C.E!  Rest. Ice. Compress. Elevate.  This will help the inflammation to go down.  itb stretch

Massage is another great therapy for ITB syndrome.  You can get a professional massage and know that it may be painful when the therapist is focusing on your tender IT band and neighboring muscle groups.  It is well worth it though!  You can also apply self massage up and down the leg.  Include your quadriceps and play around with the direction in which you massage.  DIG IN!  Use the FOAM ROLLER too!! This is a great tool to help with your ITB Syndrome.  Other great massage tools are: Roll Recovery R8 & TheraWheel.

Stretching!  Make sure you are doing your proper stretching after your workouts.  Stretch your quads, hamstrings, calfs & glutes.  Here’s a picture that can help you to stretch that pesky ITBand.

Strengthening! Be sure to practice your hip exercises & quad exercises.  Your abductor muscles may be weak and you can practice simple daily back extensions by reaching one leg behind you to squeeze your glutes and extend them out to the sides to get into the lateral portion of your hips.  You can also practice these lying down.  Simple leg circles will suffice.  Pilates and Yoga can be quite beneficial in strengthening and stretching the affected areas! Pilates and Yoga classes can also help you to gain awareness on your body alignment and you can work to balance out any muscular imbalances.

*If your ITB Syndrome is severe and none of these suggestions are helping you may want to consider seeing a physical therapist or medical professional.

Tips To Prevent ITB Syndrome:

  • Decrease your mileage & give yourself rest and recovery days if you feel your ITB acting up.
  • Walk & Warm up before your runs.
  • Check that your shoes are not worn out along the outside.
  • Avoid sloped roads that favor one side of the leg.  Run on even ground.
  • Choose trail running or natural surface as opposed to concrete surfaces.
  • If you run on a track, switch up your directions often so not to favor one side of your body.

Here’s a video and suggestions on other hip and leg exercises to help you recover from your ITB Syndrome! 

Happy Healing!! 

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About Author

Kathleen Crandall

Hello there! Kathleen Hilker Crandall Speaking! I work as an Independent Pilates/Yoga teacher and Massage Therapist in Austin, Texas. Check out our Service Page for more details on what I offer. I truly love the work that I do and am glad to share with others what I have learned! Move Well. Eat Well & Nourish to Flourish :)

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