Don’t let ITB Syndrome be a Pain this Marathon Season

We have all heard of ITB Syndrome, particularly the distance runners among us, but what exactly is it and how can you treat it or better still ‘prevent’ it from re-occurring? Read on to find out more.

Iliotibial band syndrome is characterized by pain on the outside of the knee joint, often worsening when going up or downITB Syndrome stairs or hills.  It is a very common overuse injury, particularly among distance runners.

What is the ITB?

The ITB is a sheath of thick fibrous connective tissue which helps to straighten the knee joint as well as to move the hip sideways. It attaches at the top of the thigh to the hip bone and a muscle called the Tensor Fasciae Latae then runs down the outside of the thigh and joins onto the outer surface of the shin bone.  An overactive TFL muscle can cause increased tension throughout the ITB and lateral knee.

Signs and Symptoms

  • A dull aching or burning sensation on the outside of the knee during activity
  • Sharp stabbing pain on the outside of the knee
  • The pain may not occur immediately during activity, but may intensify over time, especially as the foot strikes the ground. Pain might persist after activity. Pain may also be present above and below the knee, where the ITB actually attaches to the tibia.
  • Snapping or popping may occur when knee is straightened


  • Over-use and poor running technique
  • Over-pronation or poor foot bio-mechanics – If the feet roll in then this can cause the knee to rotate inwards, stretching and tightening the IT band.
  • Frequent running on hills or cambered roads
  • Increasing mileage too soon


  • Use the PRICE principles as well as either massage of foam rolling of the area to ease the pain. (Protect, Rest, Ice, Compression, Elevation) – Only ever apply 2 of these together at any one time
  • Decrease mileage or take a few days off (Rest)


  • Get a GAIT analysis from a professional running shop and ensure you are wearing the correct trainers
  • Strengthen the Hip Abductor Muscles (Gluteus Medius being the major hip abductor).  Stretching AND a well-structured strength plan are essential
  • Massage or Self massage (foam roller) techniques can also be very helpful in correcting excessive ITB tightness

For the majority of runners, once they rest, the pain doesn’t come back.  But this means you do have to rest (something runners are not very good at!!) immediately.  BUT, if you don’t give yourself a break from running, ITB syndrome can become chronic. Then you will need to run fewer miles and give up marathons.

In acute or prolonged cases a corticosteroid injection into the site of irritation may provide pain relief (you should seek medical advice if the problem persists long term or becomes chronic).

StrengthTraining is proven to help prevent injuries such as ITB Syndrome.  Your Personal Trainer can work with you to prescribe a strength training programme tailored to your needs.

Regular Sports Massage coupled with a programme of Corrective Exercise is also be key in the prevention of common injuries.

Contact me for a FREE consultation.

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