Iliotibial Band Syndrome (ITBS) is a common knee injury caused by inflammation on the lateral knee due to overuse, and frequent friction on the iliotibial band. The pain is at most extensive when the knee is at 30-degree flexion.

Iliotibial band syndrome results from a combination of issues including poor training habits, poor muscle flexibility, prior injury, and other mechanical imbalances in the body. ITBS is most associated with activities that require too much friction and bending of the knee, such as cycling, long-distance running, and weightlifting.

People who are at risk for ITBS are athletes, runners, cyclists, and hikers. Athletes whose activities require a lot of knee movements are likely to develop ITBS.  People who also exercise regularly are also at risk, especially when they commit training mistakes such as: not properly warming up or cooling down, straining the body, wearing improper shoes, training on wrong surfaces, using poor form, etc.


The main symptoms that may occur initially of the individual from ITBS are pain on the outer side of the knee. Initially, you will feel needle-like pricks that might go away after a warm-up, but it gets worse over time as you exercise. You might feel pain every time your heel strikes the ground. Other symptoms include:

  • Aching and tenderness outside of the knee
  • A click or a pop on the outside of the knee
  • Pain up and down your leg
  • Warmth and redness on the outside of the knee


The doctor may ask about your history and symptoms. A physical exam will be conducted to assess your body while performing specific movement patterns. Diagnosis of iliotibial band syndrome is confirmed through imaging tests such as an X-ray or an MRI scan to see and examine the pelvis’s alignment and the tightness of the iliotibial band.


Physical therapy management

  • ITBS treatment is non-operative, and physiotherapy is considered as the best treatment.

Conservative treatment

  • The doctor may strongly suggest activity modification to prevent the worsening of pain.
  • Modalities that can help alleviate the pain include ice or heat. Applying the RICE (rest, ice, compress, elevate) on the iliotibial band, followed by gentle stretching can relieve pain.
  • Corticosteroid injections and the use of anti-inflammatory medications can also treat ITBS.

People with ITBS usually recover in about six weeks. Some other necessary do to help ease the pain are:

  • Take over-the-counter pain relievers.
  • Wrap an ice-pack in a towel and put in on your knee for 10-15 minutes at a time
  • Exercise Management: consult your physical therapist for the best sets of exercise for you. Usually, passive or static stretching is the best start. A physical therapist can also:
    • Give you tips on how to warm up and cool down, which may somehow relieve the pain.
    • Help you choose the proper clothing and gears.
    • Show your exercises, routines, and series of movements that can strengthen and stretch your iliotibial band.
    • Advise or tell you on the best training schedule of time that you could do the exercise routines.
    • Teach you how to improve your form and body structure to obtain fitness.
    • You may use friction, massage, ice, or ultrasound could also do the work.

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