ITB friction syndrome is a relatively common injury that affects runners. A typical presentation is that of pain on the outside of the knee, it sometimes catches and generally gets worse the more you run through symptoms. 

It is caused by the ITB tendon rubbing against a small projection of bone (lateral epicondyle) on the outside of the knee as the knee bends and straightens. 

Certain kinds of biomechanics and muscle activation patterns can lead to the over recruitment and eventual tightening of ITB, which can predispose to the onset of ITB friction syndrome. 

Treatment can be aimed at 

  1. Reducing pain and inflammation with ice, anti-inflammatories and sometimes corticosteroid injections. 

  2. Loosening the ITB with different massage techniques, stretching and release strategies. 

  3. Addressing biomechanical and motor patterns.  This might include orthotics, increasing activation and strengthening of the gluteals and core muscles. 

  4. Load modification.  It is difficult for this condition to resolve if you are doing all the right things but getting the running loads wrong.  You should not run through pain with this problem.   

The length of time it takes for ITB friction syndrome to resolve varies considerably.  In the vast majority of cases it will resolve, however for the most chronic, or with longstanding recurrent cases, there are surgical options available.

Alan Davies

APA Sports Physiotherapist