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Iliotibial Band Syndrome Physiotherapy



Iliotibial band syndrome (ITBS) is one of the most common causes of knee pain, particularly in individuals involved in endurance sports such as

  • running (including athlons like biathletes and triathletes)
  • cycling

In fact, ITB accounts for up to 12% of running injuries and up to 24% of cycling injuries.

Iliotibial band syndrome is typically managed conservatively with physical therapy and temporary activity/exercise modification.

first of all, What is Iliotibial Band Syndrome (ITBS)?

Iliotibial band syndrome (ITBS) typically happens when excessive irritation causes pain at the outside (or lateral) part of the knee.

The iliotibial band (ITB), often called as the "IT band" is a type of soft tissue that runs along the side of the thigh from the pelvis all the way to the knee.

As it  nears and approaches the knee, its shape thickens as it crosses a prominent area of the thigh bone (the femur), called the lateral femoral condyle.

At or near the pelvis, the ITB attaches to 2 important hip muscles, the tensor fascia latae (TFL) and the gluteus maximus.

Irritation and inflammation arise from friction between the ITB and underlying structures when an individual moves through repetitive straightening (extension) and bending (flexion) of the knee.

Most of the time, iliotibial band syndrome pain happens with overuse during activities such as running and cycling.

ITBS involves many lower extremity structures, including muscles, bones, and other soft tissues, the number #1 discomfort arises from:

  • Abnormal contact between the ITB and thigh (femur) bone
  • Poor alignment and/or muscular control of the lower body
  • Prolonged pinching (compression) or rubbing (shearing) forces during repetitive activities

The common structures involved in ITBS are:

  • Iliotibial band
  • Bursa (fluid-filled sack that sits between bones and soft tissues to limit friction)
  • Hip muscles

ITBS typically occur in but is not limited to:

  • Athletes who performs repetitive activities, such as squatting
  • Atheletes who participate in endurance sports such as running and cycling
  • Individuals who spend long periods of time in prolonged positions, such as sitting or standing for a long workday, climbing or squatting, or kneeling
  • Individuals who quickly start a new exercise regimen without proper warm-up, transition or preparation

Signs and Symptoms

With ITBS, you may experience:

  • Stabbing or stinging pain along the outside of the knee
  • A feeling of the ITB “snapping” over the knee as it bends and straightens
  • Swelling near the outside of your knee
  • Occasionally, tightness and pain at the outside of the hip
  • Continuous pain following activity, particularly with walking, climbing, or descending stairs, or moving from a sitting to standing position

ITBS pain is usually most intense when the knee is in a slightly bent position, either right before or right after the foot strikes the ground as this is the point where the ITB rubs the most over the femur.

How Is iliotibial band syndrome Diagnosed?

Our senior physiotherapist will ask you questions about your medical history and activity regimen.

A physical examination will be performed so that we can collect information on

  • movement (range of motion)
  • strength
  • flexibility measurements at the hip, knee, and ankle

When dealing with ITBS, it is also common for our senior physical therapist to use special tests and complete a movement analysis, which will provide information on the way that you move and how it might contribute to your injury.

This could include assessment of

  • walking or running mechanics
  • foot structure and
  • balance

We may have you repeat the activity that causes your pain to see firsthand how your body moves when you feel pain. If you are an athlete, we might also ask you about your

  • chosen sports, activities or exercises
  • shoes you wear for training
  • training routes and
  • exercise routine

Typically, medical imaging tests, such as x-ray and MRI, are not needed to diagnosis ITBS.

how our senior physiotherapists can help you

We will use treatment strategies to focus on:

Range of motion

Often, abnormal motion of the hip and knee and foot joint can cause ITBS because of how the band attaches to hip muscles. We will assess the motion of your injury leg compared with expected normal motion and the motion of the hip on your uninvolved leg.

Muscle strength

Hip and core weakness can cause, aggravate and contribute to ITBS.

The "core" refers to the muscles of the abdomen, low back, and pelvis. Patients need to note that core strength is important, as a strong midsection will allow greater stability through the body as the arms and legs go through various motions.

For athletes performing endurance sports, it is important to have a strong core to stabilize the hip and knee joints during repetitive leg motions. We will be able to determine which muscles are weak and provide specific exercises to target these areas.

Manual therapy

Our senior physiotherapists are trained in manual therapy, which means they use their hands to move and manipulate muscles and joints to improve motion and strength. These techniques can target areas that are difficult to treat on your own.

We may also use the following:

Functional training

Even when an individual has normal motion and strength, it is important to teach the body how to perform controlled and coordinated movements so there is no longer excessive stress at the previously injured structures.

We will develop a functional training program specific to your desired activity. This means creating exercises that will replicate your activities and challenge your body to learn the correct way to move.

We will also work with you to develop an individualized treatment program specific to your personal goals. We will offer tips to help you prevent your injury from reoccurring.



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book your physio appointment or enquire now

Email questions and your preferred physiotherapy timings to nigel@phoenixrehabgroup.com or

WhatsApp / SMS your name, preferred date, time and enquiries to +6588001830

Clinic Locations: See how to get to us here

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ALTERNATIVE THERAPIES

All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).

See our entire team here with introductions and their specializations.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

Follow up sessions are inline to 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.

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book your physio appointment or enquire now

Email questions and your preferred physiotherapy timings to nigel@phoenixrehabgroup.com or

WhatsApp / SMS your name, preferred date, time and enquiries to +6588001830

Clinic Locations: See how to get to us here