Print Friendly and PDF

Iliotibial Band Friction Syndrome

This is a very common condition most often afflicting new cyclists or runners, and it often presents as a stinging pain at the side or length of the affected knee and hip.

The Iliotibial Band Syndrome (ITBS), also known as Iliotibial Band Friction Syndrome (ITBFS), is a very common thigh injury that is commonly known to runners, cyclists and hikers. It gets is name from the Iliotibial Band (refer picture inset) rubbing in friction against a bony protusion at the side of your knee or at your hip. You see, the ITB is a band that continues from our largest hip muscles and it’s a really thick band of fibrous tissue just outside at the side of our thighs. The muscle originates from the pelvis, and extends over the side of the hip and inserts below the knee.

Just before it inserts into the knee, it runs over a bony protusion in the thigh bone (which is the lateral femoral epicondyle). The repeated friction of this band over this bony protusion caused by repeated bending and straightening of the knee (think runners, cyclists and hikers) causes internal “friction burn” and irritates the band, and this causes inflammation. The more tight and taut our ITBs are, the harder it rubs over the protusion and the higher the friction and inflammation rate…and the more painful, of course.

Not only runners, cyclists and hikers get this. It is also commonly develops in people who suddenly increases their level of activity without gradual increase, such as people who suddenly pick up a sport or start running. Risk factors includes abnormal walking patterns such as overpronation of the feet (where the feet goes inwards because of collapsed arch or habit), leg length discrepancies or bow-legged syndrome. The most vulnerable range of knee flexion that starts and perpetuates this condition is when the knees are flexed at 30 – 40 degrees – this is where the ITB crosses (frictionally) over the lateral femoral condyle.

 What causes tightening of the Iliotibial Band?

Fundamentally, there are a total of THREE (3) things that causes tightness to the ITB, and they are: 

  1. Improper training/training methods
  2. Improper walking patterns
  3. Weakness of the outer thigh muscles 

Improper Training/Training Methods 

When runners or hikers participate in improper training, such as too fast an increase of intensity (sudden spike in speed or distance training without a gradual training plan); or training over inappropriate surfaces such as banked surfaces or commonly seen downhill running – all these increases strain over the ITB. Cyclists who tend to point their toes inwards instead of neutral forwards-facing pulls the ITB to more length, causing it to work harder along the extended length, naturally tightening the ITB.

Improper Walking Patterns

Foot structures that are/have arches that are too high or low as well as having leg length discrepancies (this means that there is uneven leg length) almost always causes the ITB to tighten on one side, because one side is worked harder than the other, causing compensation and overworking. In this, physiotherapy biomechanical assessment on your walking pattern will identify and pinpoint the problem and we can work on muscles and joints; where it is appropriate, supporting foot orthotics such as insoles may help to correct or minimise these problems.

Weakness Of The Outer Hip Muscles

Weakness of our outer hip muscles tends to cause our iliotibial band to overwork to compensate for it. This causes our ITB to become tight and gradually becoming an Iliotibial Band Friction Syndrome. A combination of deep tissue massage/release to loosen ITBs, stretching and strengthening the weak outer hip muscles will help to diffuse the load across and ensure that our ITB don’t overwork.


Well, even though one may have cautiously managed and avoided all the three abovementioned points, still, athletes who clocks high training hours, volume and intensity almost always have painful ITBs because of their high intensity training. In such situations, regular deep tissue release and massage with our sports massage/deep tissue release therapist will help to release the tight band (see who your therapist will be), and keep it at optimal length for best sports and training performance.

Please don’t forget to stretch your ITB after every session of exercise and training or games. Too much and too long of ITB tightness can even lead to pain in the deep muscles of your groin and even to low back pain because it may alter the way you move and cause improper walking.

Back to Top

Our Physio & Rehab Expertise

Specialist Rehab Group works with specialist physiotherapists and specialist rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.

Areas of specialization

  • physiotherapy: back and neck (spine), sports, shoulder, hip, knee, ankle
  • hand therapy: forearm, wrist, hand and fingers
  • podiatrist: leg, calf, ankle, foot and toes
  • read more on our specializations here

All our therapists are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCM). See our entire team here by location and specialization.

Initially, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover. They then provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

To call for inquiries or appointments, please contact us at:

SMS/Call/Whatsapp: 96402670


Tell A Friend About Us

We appreciate you as a patient and want you to know that the #1 way we grow as a clinic is through word of mouth referrals from valued patients like yourself.

We do not rely on advertising - instead, we prefer and appreciate the goodwill and positive reinforcement from patients.

When you have the opportunity, please take the time to tell your family, friends and physicians about the positive results and experience you have had in our clinic.

Thank you so much, and stay healthy!

Please Call/SMS/WhatsApp to
xx, thanks!

We are a wholly Singapore Private Limited group of licensed physiotherapists, hand therapists, podiatrists, chiropractors, sports massage therapists, clinical pilates practitioners and TCM physicians practicing in our scope of rehabilitation and its areas of specializations. As listed in our website are the list of services we provide our clients as referred by their medical doctors or by self referrals/word of mouth.

The range of rehabilitation results vary from patients to patients, depending on a variety of factors and reasons such as severity of condition, genetics, gender and age. However, we will still deliver the best evidence-based-practice of physiotherapy, hand therapy, TCM, sports training and deep tissue release therapy that we can deliver.

The information available on this site is for educational purposes only, if you need a full professional advise on physiotherapy, hand therapy and occupational therapy, please schedule an appointment with us by contacting our staff by Call/SMS/WhatsApp at xx, thanks!




You can also text or WhatsApp and we will call you back too =)


Physio, Rehab &  Insurance

Your physio, hand therapy and rehab with us may be covered under your medical insurance or cashless - find out more here.


Acupuncture TCM
Balance Physiotherapy
Biomechanics Physiotherapy
Chest Physiotherapy
Clinical Massage Physiotherapy
Clinical Pilates
Cold Therapy Physio
Complementary Physiotherapy
Cupping TCM
Deep Tissue Massage
Desensitisation Physiotherapy
Electrotherapy Physio
Ergonomics Physiotherapy
Exercise Physiotherapy
Gua Sha TCM
Falls Prevention Physiotherapy
Hand Physiotherapy
Heat Physiotherapy
Home Physiotherapy
Ice Physiotherapy
Interferential Physiotherapy
Manipulation Physiotherapy
Muscle Stimulation Physio
Musician Physiotherapy
Stroke/Neuro Physiotherapy
Orthopedic Physiotherapy
Hand Splinting Physiotherapy
Pain Management TCM
Pain Relief Physiotherapy
Post Amputee Physiotherapy
Post Surgery Physiotherapy
Postural Physiotherapy
Re-Education Physiotherapy
Physiotherapy Singapore
Relaxation Physiotherapy
Sonophoresis Physiotherapy
Splinting Physiotherapy
Sports Physiotherapy Massage
Physiotherapy Stress Relief
Swelling Physiotherapy
TENS Physiotherapy
Tension Headaches Physiotherapy
Thermal Physiotherapy
Traction Back Physiotherapy
Trigger Point Physiotherapy
Ultrasound Physiotherapy
Wax Heat Physiotherapy


Finally I know what I have, my pain decreased and now I'm back to work!

Regional Sales Manager

OMG. The pain levels in my hands have dropped dramatically, about 60-70%


Read more testimonials