11/04/2026
Iliotibial Band Syndrome (ITBS) is one of the most common overuse injuries seen in runners, cyclists, and active individuals. While it often presents as a sharp or burning pain on the outside of the knee, the root cause is usually more complex than the knee itself. With the right assessment and treatment plan, ITBS is highly manageable - and most people can return to pain-free movement.
The iliotibial band (IT band) is a thick band of connective tissue that runs down the outside of the thigh, from the hip to just below the knee. Its role is to help stabilise the hip and knee during movement, particularly during walking, running, and cycling. Problems can arise when this band becomes overloaded or excessively tight, leading to irritation where it passes over the outer knee. ITB Syndrome occurs when the IT band repeatedly rubs or compresses tissues near the outer knee, causing pain and inflammation.
Common ITB Syndrome symptoms:
Pain on the outside of the knee, especially during activity
Discomfort that worsens with running downhill or on cambered surfaces
Pain that starts during exercise and eases with rest (at first)
Tenderness when pressing on the outside of the knee
Tightness along the outer thigh or hip
Common ITB Syndrome causes include:
Sudden increases in training volume or intensity
Poor hip or gluteal strength
Reduced control of the hip and knee during movement
Limited ankle or hip mobility
Running or cycling technique issues
Inadequate recovery between sessions
Assessment is key to figure out the root cause of the issue and not just treating the symptoms. Hands-on therapy to help reduce irritation, alongside targeted strengthening particularly of the glutes and hip will help with mechanics during exercise. While stretching and foam rolling can help relieve surrounding muscle tension, the IT band itself is very strong and doesn’t “stretch” easily. These tools are best used as supporting strategies that address the issue. With the right assessment and treatment alongside recovery, ITB Syndrome is very treatable with most people making a full recovery and returning to doing what they love.