ITB Friction Syndrome…what is it?

 In Lower Limb

What is ITB Friction Syndrome?

ITB friction syndrome (ITBFS) is a condition affecting the outside of the knee close to where the Iliotibial Band inserts into the knee. The iliotibial band is a strong band of connective tissue that covers the outside of the thigh and helps stabilise the knee and pelvis.

How is it caused?

ITBFS is typically an overuse running injury which tends to affect distance runners more than sprinters.  It is caused by continual friction of the ITB over the bursae (fluid filled sac) or where the band inserts into the bone leading to inflammation and pain.


What are the contributing factors ?

–          Poor running technique

–          Muscle weakness of gluteal, abdominal, quadriceps and groin muscles

–          Training load such as increased distance or hill training (especially downhill)

–          Poor footwear

–          Foot pronation

–          Bone structure


Symptoms include:

–          Pain (dull ache to very sharp pain) over the outside of the knee with weight bearing

–          Swelling and tenderness over the outside of the knee


Diagnosis of ITBFS can be carried out by your physiotherapist however for accurate diagnosis of ITB bursitis this is done under ultrasound or MRI.


Treatment and management options and goals include:

–          Normalising muscle length, strength and control around the pelvis

–          Modifying load and resting where necessary

–          Offloading the ITB (release, roller, strength work and taping)

–          Running technique correction

–          Orthodic prescription or footwear modification

–          Anti-inflammatory medication or Cortisone if ITB Bursitis

–           In severe cases of ITBFS surgery to lengthen the ITB (lateral release) can be carried out. Response to this surgery still remains quite poor so it is a last resort.

Lindsay Christie

POGO Master Physio

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