ITB Friction Syndrome (runner’s knee)

Iliotibial Friction Syndrome is a common cause of what is often referred to as ‘Runner’s Knee’ and can account for up to a quarter of over-use injuries in runners. It is often caused from general over-use and repetitive trauma rather than from one specific incident.

The iliotibial band attaches to the outer border of the tibia or shin bone. It crosses the knee and can rub across the bone on outside of the joint as it slides back and forth. This repetitive sliding can create excess friction, especially when the knee is bent at 30 degrees, which commonly happens just as your foot touches the ground when running. This friction can cause inflammation, swelling and associated pain.

Pain may radiate up the outside side of the thigh. The pain usually only comes on with exercise, typically running, and often only comes on after a set distance or time from onset of exercise. The pain normally eases fairly rapidly with rest, although a persistent aching around the area is common.

What is the Iliotibial Band?

The iliotibial band is a long, thin band of fibrous tissue that runs down the outside of your thigh. At the top of your thigh it is attached to your Tensor Fascia Latae (TFL) muscle and Gluteus Maximus, and at the bottom it attaches to your tibia (lower leg bone) and femoral condyle on lower outside portion of the thigh bone.

What causes ITB Syndrome?

Causes of ITB friction syndrome include , the bone on the outside of the knee being particularly prominent, the ITB being over-tight, increased exercise regimes or altered running or exercising biomechanics. Biomechanics can alter due to a muscle imbalance (weakness or tightness), fatigue and/or ground impact issues.

The mainstay for treatment is physiotherapy and podiatry which will address muscle tightness and balance. A steroid injection can speed recovery. Surgery is almost never required.

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