ITB friction syndrome is an overuse injury to some of the soft tissue structures on the outside of the knee. The ITB is a large band of connective tissue that runs from the hip down the outside of the thigh and attaches just below the knee joint.

ITB friction syndrome is caused by repetitive rubbing of the iliotibial band against the bone on the outer side of the knee.

This excessive rubbing against the bone can irritate the ITB itself and/or other surrounding soft tissue structures.

Muscle tightness to tensor fascia latae and gluteus maximus increases the tautness of the ITB and this equates to increased tension at the tendon insertion into the knee.

Causes of the excessive friction include:

  • Incorrect training technique

  • High volume training/over training

  • Increasing distance run or cycling too quickly

  • Structural abnormalities

  • Wearing improper and/or worn out shoes for athletic activity

  • Failing to stretch properly

  • Muscle imbalances due to not strengthening opposing muscles (for example; the quadriceps and hamstrings)

Symptoms of ITB Friction Syndrome include

  • Dull aching or burning sensation on the outside of the knee during activity

  • Sharp stabbing pain on the outside of the knee during activity.

  • The pain may be localized, but generally it radiates around the outside of the knee and/or up the outside of the thigh. Pain typically starts as minor discomfort and progressively worsens. A snapping sensation may be present when the knee is bent and then straightened.

Treatment may include:
Rest – restriction from activities that cause pain

Heat or Ice – application of heat, ice. Generally ice is applied after activity; heat may be used before exercise to loosen muscles and soft tissues.

Myotherapy treatment – soft tissue treatment and dry-needling to ITB, hip and leg musculature

Corrective Exercise – stretching to lengthen the ITB and strengthening the quadriceps and hamstrings, and gluteal muscles to correct muscle imbalances as prescribed by your myotherapist.

Avoiding the causes of ITB Friction Syndrome is the best way to prevent it. This can include:

  • Learning proper training techniques

  • Wearing appropriate shoes and equipment for each sport

  • Replacing athletic shoes as they show signs of wear

  • Being aware of running surfaces

  • Increasing training volume and intensity gradually

  • Strengthening quadriceps and hamstrings

  • Stretching the ITB

  • Regular Myotherapy treatment to maintain normal muscle condition