Iliotibial Band Syndrome (ITBS) is one of the most common and debilitating injuries that runners can suffer.
Why does this issue seem so difficult to fix? And once fixed, why does it seem to come back again so quickly?
Treating Iliotibial Band Syndrome
Traditional treatments don’t work
Read most magazines and the recommended approach is massage and foam rolling. Unfortunately, because the ITB is essentially a tendon, it doesn’t have great blood flow. Tendons are not supposed to be stretched or elongated like muscles so there is little value in treatments like massage and foam rolling. (But there is one way that foam rolling can help.)
Drugs can delay healing
Anti-inflammatory treatments, whether in the form of icing or drugs like ibuprofen, may reduce the pain but they won’t help you recover. Inflammation is our bodies ways of marshalling resources to fix a problem. Taking the inflammation away can actually slow recovery.
Time heals all wounds
The pain of ITBS comes from irritation of the fat pad located around the outside of the knee. That means that time plays an important part in recovery. By giving the aggravated area a break, most people find pain disappears completely and that they can resume running within six weeks.
Tip: Eat fewer inflammatory foods (think dairy, sugar and alcohol) so that your body can focus on the injury rather than fighting additional inflammation.
Fix the cause, not the symptom
Not running for a period of time may fix the problem, but won’t stop it from coming back. In order to prevent ITBS, you first need to understand what the ITB is responsible for in your body. In combination with a few important muscles, the ITB is responsible for providing lateral stability and making sure our knee moves in a straight line rather than “dropping in” when running (and cycling).
The trick lies in those muscles that help the ITB – the Gluteus Medius and the Tensor Fasciae Latae.
By activating and strengthening these muscles, the ITB can do its job without causing you pain. Exercises such as lateral leg raises are great exercises for strengthening these muscles but do little to control how they activates as part of the running movement.
Try this instead: Three single leg squat variations:
Regular practice is key with these exercises, as you’re teaching your body a behaviour it will rely on next time you lace up your running shoes.
Fredericson, M., & Wolf, C. (2005). Iliotibial band syndrome in runners: Innovations in treatment. Sports medicine (Auckland, N.Z.)., 35(5), 451–9.
Noehren, B., Schmitz, A., Hempel, R., Westlake, C., & Black, W. (2014). Assessment of strength, flexibility, and running mechanics in men with iliotibial band syndrome. The Journal of orthopaedic and sports physical therapy., 44(3), 217–22. Retrieved from
Last updated on March 7th, 2021.