Suffering from knee pain on the outside of your leg? You might have Iliotibial Band (ITB) Syndrome, a common overuse injury in runners, cyclists, and endurance athletes. But despite its prevalence, there’s a lot of misinformation about ITB Syndrome. In this guide, we’ll debunk the biggest myths about ITB pain and provide expert-backed strategies for faster recovery and long-term injury prevention.

Table of Contents

Myth #1: It’s just a “Runner’s Injury”

Many people associate ITB Syndrome exclusively with runners. While running is a common trigger, it’s not limited to those who run long distances or frequently. ITB Syndrome can affect anyone who engages in repetitive knee-bending activities, including:

• 🚴 Cycling
• 🏕️ Hiking
• 🏋️ Weightlifting
• 🏀 Basketball & Soccer (Fredericson & Wolf, 2005; Powers et al., 2022)

✅ What You Can Do:

• Incorporate strength training and mobility exercises to lower ITB irritation.
• Maintain proper biomechanics in all knee-dominant movements.

Myth #2: ITB Syndrome Is Caused by a Tight ITB

A common misconception is that a “tight ITB” causes friction against the femur, leading to pain. However, research shows the ITB is a passive structure, meaning it doesn’t contract like muscles. The real issue often lies in muscle imbalances, particularly in the:

• Glutes (weak stabilisers increase strain on the knee)
• Quadriceps (overactive vs. underactive muscles create instability)
• Hip Flexors (tightness can alter biomechanics) (Fredericson et al., 2000; Powers et al., 2022)

✅ What You Can Do:

• Strengthen your glutes, quads, and core to improve knee stability.
• Address movement patterns with running gait assessments.

Myth #3: Does Foam Rolling Fix ITB Syndrome?

Foam rolling is popular for recovery, but directly rolling the ITB may not be as effective as many believe. The ITB is a dense, fibrous band that doesn’t “release” like muscles. Over-rolling it could actually cause more irritation (Falvey et al., 2010; Bazett-Jones et al., 2022).

✅ What You Can Do:

• Hip Flexors (correct tightness)
• Instead of rolling the ITB, target surrounding muscles like: Glutes (hip mobility) and quads (reduce tension on the knee)

Myth 4: Rest is the best treatment

While rest helps short-term symptom relief, extended rest without rehab can lead to muscle weakness and higher reinjury risk (Noehren et al., 2007; Bazett-Jones et al., 2022).

✅ What You Can Do:

• Engage in active rehabilitation, including:
  • ✅ Strength training (glutes, quadriceps, core)
  • ✅ Flexibility training
  • ✅ Gait and movement analysis
• Work with a physiotherapist or osteopath for personalised rehab.

Myth 5: It’s because you have poor running form

While biomechanics influence injury risk, ITB Syndrome is not just about running form. Other key factors include:

• Muscle weakness (hips, glutes, quads)
• Footwear issues (worn-out or improper running shoes)
• Training errors (sudden mileage increases) (Messier et al., 1995; Esculier et al., 2018)

✅ What You Can Do:

• Address multiple risk factors: strength, footwear, training load.
• Avoid sudden spikes in mileage or intensity.

Myth 6: ITB Syndrome Is Only a Short-Term Injury

Some cases resolve with time, but chronic ITB Syndrome requires targeted intervention. It can become a long-term issue if untreated, leading to recurrent flare-ups (Jelsing et al., 2013; Esculier et al., 2018).

✅ What You Can Do:

• Seek early intervention to prevent long-term complications.
• Incorporate prevention strategies, such as proper warm-ups and strength training.

Best Ways to Treat & Prevent ITB Syndrome

If you’re experiencing knee pain from ITB Syndrome, here is how to recover faster and prevent it from returning:

🔹 Strength Training for ITB Health:

• Glute activation exercises (side-lying leg raises, clamshells)
• Quadriceps strengthening (step-ups, lunges)
• Core and hip stability work (planks, single-leg deadlifts)

🔹 Smart Training Adjustments:

• Avoid sudden increases in mileage or intensity
• Crosstrain with swimming and cycling to reduce knee stress
• Warm-up with dynamic mobility drills before running

🔹 Professional Help:

• A gait analysis can help correct biomechanical imbalances
• Osteopaths and physiotherapists can create a personalised rehab plan
• Consider a running shoe assessment to ensure proper support

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Frequently Asked Questions (FAQs)

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Are you struggling with knee pain from ITB Syndrome? Our team of Osteopaths and physiotherapists at Stay Tuned Sports Medicine specialises in running assessments, injury prevention, and rehabilitation. Book an appointment today to fix your ITB pain and get back to peak performance!

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References

• The effect of hip strengthening on iliotibial band syndrome in runners
• The role of lower limb biomechanics in iliotibial band syndrome
• Biomechanical factors associated with iliotibial band syndrome in distance runners
• The role of the iliotibial band in the etiology of lateral knee pain in endurance runners
• Prospective study of the biomechanical factors associated with iliotibial band syndrome
• Hip abductor weakness in distance runners with iliotibial band syndrome
• Diagnosis and management of iliotibial band syndrome: A review of the literature