ITB Pain – Runner’s Knee Pain

ITB Pain or ITB Friction Pain

The ITB (Iliotibial Band) is a band that runs from the pelvis to the outside of the thigh and attaches to the outside of the knee. The ITB passes across the bony prominence on the outside of your knee and has a sensitive fat pad underneath this point. We have more information about it here (



There has been some debate about the ITB. Some research studies claim the ITB helps with the stability of your knee and acts like a ligament. Some research studies say the ITB acts like a tendon and allows yours hip muscles to attach to the knee and help control your knee alignment.

We commonly see this problem in runners. July and August see quite a few cases as people prepare for events like the City2Surf and Blackmores marathon. Various studies into the condition find that ITB pain occurs in 2-15% of runners.

A 2009 paper in the Strength & Conditioning Journal identified some possible risk factors for runners who develop ITB pain:

  • Narrow stance width during running
  • Running with a long stride and heel strike
  • Always running with same leg closest to centre of road and exposed to the same camber/slant of the footpath
  • While leg length discrepancies are controversial, some ITB pain sufferers may experience it on the longer leg

How physiotherapy can help

Addressing these factors can help prevent the problem. However, if you are one of the unlucky ones who goes on to experience ITB pain, there are still ways to treat the problem. Seeing a Physiotherapist can help determine some or all of the following treatments:

  • Hip strengthening exercises (clams, bridges, squats, leg press, hip abduction)
  • Hip control exercises (single leg squats, step ups, step downs)
  • Shortening your stride and increasing your step rate
  • Stretching
  • Foam roller massage of the ITB and hips
  • Footwear considerations

As not everyone needs all of these treatments, your Physiotherapist can tailor a customized rehabilitation program for you. Your Physiotherapist can also determine if you need to see your GP or Sports Physician about medications or more invasive interventions.


written by Garett Van Oirschott