Conditions we treat
ITB Syndrome
Reviewed by Andrew Macdonald, Senior Physiotherapist — AHPRA registered, APA member
What is ITB Syndrome?
The iliotibial band (ITB) is a band of connective tissue running from the hip down the outside of the thigh to just below the knee. ITB syndrome develops when this tissue becomes irritated from repetitive friction against the thigh bone near the knee — common in runners and cyclists, particularly after an increase in training volume, distance, or hill running.
Symptoms
The hallmark symptom is a sharp, burning pain on the outside of the knee, typically appearing after a consistent distance or time into a run and easing with rest, though it can start earlier and earlier as the condition progresses.
Treatment
ITB syndrome is rarely just a problem with the band itself — it’s usually driven by weakness through the hip and glutes affecting how the leg loads during running. Andrew’s treatment combines manual therapy and soft tissue work through the hip and outer thigh with a targeted hip and glute strengthening programme, alongside a review of training load to identify what triggered it. Addressing the underlying strength and loading pattern, not just resting until it settles, is what prevents it returning once you’re back to full training.
How we treat it
Treatments used for itb syndrome
Manual TherapyManual therapy uses hands-on techniques — soft tissue work, trigger point therapy, joint mobilisation and fascia distortion release — to ease pain, restore movement and speed recovery.
Exercise RehabilitationA structured, progressive exercise programme — tailored to your condition and stage of recovery — to rebuild strength, restore movement and prevent injuries recurring.Frequently asked questions
Can I keep running with ITB syndrome?
Often not comfortably, since ITB pain tends to worsen the longer or further you run. Andrew will guide how to modify your training while addressing the underlying hip strength and loading pattern driving the problem.
What causes ITB syndrome in runners?
Most commonly, weakness through the hip and glutes affecting how the leg loads during running, often triggered by a sudden increase in training volume, distance, or hill running.
Does foam rolling help ITB syndrome?
It can help ease symptoms temporarily, but it doesn't address the underlying hip strength and loading pattern that's actually driving the problem. A targeted strengthening programme is what resolves it long-term.
How long does ITB syndrome take to resolve?
Many cases improve within 4 to 6 weeks of a targeted hip strengthening programme and appropriate training load management, though longstanding cases can take longer.
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