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Iliotibial Band Friction Syndrome

What it Effects

  • The Iliotibial band causing pain on the outside of the knee due to overuse

Who it Effects

  • Runners
  • Cyclists
  • People with a tight Iliotibial band

Mechanism of Injury

  • The Iliotibial band moves in front and behind the lateral epicondyle of the knee on movement. On repeated movements it can become impinged on the lateral epicondyle (especially if you have a tight Iliotibial band) and the friction occurring causes inflammation and pain as a result
  • A fluid filled sac designed to prevent friction (a bursa) can also become inflamed and painful with this condition if it becomes impinged between the Iliotibial band and the lateral epicondyle
  • Poor posture can contribute to this condition
  • Doing to much too soon

Signs and Symptoms

  • Pain on the outside of the knee on activity
  • Pain is not usually present at rest
  • Point tenderness on lateral epicondyle
  • Possible tightness when applying medial glide to patella due to tight lateral structures


  • Correct postural dysfunction that may be contributing to condition e.g. leg length discrepancy
  • Stretching of tensor fascia latae which attaches to the Iliotibial band
  • Strengthen the Gluteal muscles particularly Gluteus Medius
  • Orthotics
  • Ultrasound

Additional Information

  • If Gluteus Medius is weak it allows the leg to internally rotate during movement, this puts added stress on the Iliotibial band increasing the likelihood of this condition, therefore strengthening of Gluteus Medius can help prevent this condition
  • A decreased arch in the foot can contribute to this condition as the increased pronation stresses the outer side of the knee therefore stressing the Iliotibial band
  • Running on a slanted pavement can cause this condition on the knee nearest to the curb, as it simulates a false leg length discrepancy i.e. the leg nearest to the slopping curb is longer that the other. This puts tension on the Iliotibial band. Runners should therefore try to run on flat surfaces, if that’s not possible don’t always run the same way round the block

If you have any questions, please use the comment form below or post a thread on the forums.

— Phil @ 9:34 pm, July 12, 2006

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