Iliotibial Band Friction Syndrome

This syndrome involves the compression of the iliotibial band (ITB) on the lateral femoral condyle (the bony prominence on the outside of the knee).

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This is primarily due to suboptimal hip control (usually genu or dynamic valgus or ‘knock knees’), and associated tight outer hip/leg muscles. The compression causes friction between the ITB and the condyle, which causes subsequent inflammation and pain.


Client will report pain on the outside (lateral) knee, and/or outer thigh pain. The client may also report a ‘snapping’ type feeling with certain activities. Pain can be an ache, or occasionally sharp in nature.


  • Activities that flare up this pain are usually running (especially a dramatic increase in distance or downhill running) and stairs.
  • Local swelling and tenderness over the outer knee.
  • Tightness in quads and ITB, and commonly outer hip/glutes.


  • A period of active rest – load management to let the pain settle. This often involves decreasing your running distance/load initially.
  • Release of tight outer leg/hip musculature – this involves dry needling or deep tissue massage of the ITB, TFL, quads, glutes (depending on what is tight for the individual client).
  • Correcting lower limb posture and biomechanics – and often this involves strengthening the hip external rotators and abductors (glutes).
  • Advice regarding anti-inflammatories, and home releases (with the trigger ball & foam roller).

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