What is ITBS?

Iliotibial Band (ITB) Syndrome can result from any activity that causes the leg to turn inward repeatedly, such as wearing non-supportive shoes or running downhill. The ITB is not a muscle. It is a thick band of tissue called fascia that starts on the outside of the hip, passes down the outside of the thigh and inserts into the side of the patella (knee cap) and the tibia (shin bone).


  • The most notable symptom is swelling and pain on the outside of the knee, and is often mistaken for a knee injury
  • A sharp or burning pain on the outside of the knee
  • During the early stages of the injury, symptoms will often subside after the run is over, but will return with the next run. If no action is taken to treat the injury, pain can occur during exercise, and will become more persistent after exercise
  • Tenderness on outside of knee


  • Most likely due to friction of tight ITB rubbing at the hip and/or knee.
  • Tight or weak hip muscles
  • Excessively flat feet or high arches
  • Poor ankle range of motion
  • Sudden increase in mileage
  • Sudden increase in intensity of training
  • Poor running technique or form (e.g. overstriding)
  • Worn out running shoes
  • Not warming up or cooling down properly


  • REST following the development of pain in the hips, knees or ankles. ICE is most effective during the first 72 hours or when inflammatory signs are present. COMPRESSION using stockings or bandages reduces pain, swelling and tissue damage. ELEVATION of the leg helps to control pain and swelling. REFERRAL to a sports doctor or physiotherapist to assess the injury, the specific factors contributing to the injury, how these factors can be corrected, the extent of the injury and recovery time.
  • No exercise is usually encouraged during ITBS recovery. However, some individuals chose to engage in different activities while recovering. Keep in mind, any exercise that causes pain should be completely avoided. This is vitally important, since pain-free exercise allows the body to begin the healing process in the absence of further tissue damage.


  • Perform ITB stretching exercises
  • Ensure running shoes have adequate support and cushioning
  • Incorporate rest into your training
  • Include cross training to condition different muscles and provide variety (e.g. rowing machine)
  • Warm up and cool down properly