Raasay Waters Sports Therapy Cape Town

iliotibial band (ITB)

iliotibial band (ITB)

The iliotibial band (ITB) is not a muscle but a thick band of connective tissue that stretches from the outside of the pelvis down past the knee joint to the outside of the shin bone (tibia). There are two muscles that insert into the band, the gluteus maximus and tensor fasciae latae. The ITB is important in providing lateral stability to the knee.

As the name suggests, there is a point of friction which can cause pain: as the knee straightens and bends during running the ITB can rub on the outside of the femur. This may lead to inflammation of the band or underlying tissue. A common misconception is that the ITB is tight and that this is what causes the problems. There are people who do present with tightness, but this is often as a result of something more complex. So treating the tightness rarely makes the pain go away.

What causes it?

Inflammation of the iliotibial band occurs because of overuse and is most often seen in marathon or other long-distance runners. Mechanical issues with poor flexibility and decreased strength in the quadriceps muscles of the thigh lead to the inflammation. Factors such as leg length discrepancy, an abnormal pelvic tilt, weak glutes and weak core may cause iliotibial band syndrome because of excess stretching of the IT band across the femoral condyle.

Training errors in long-distance runners (for example, running on one side of the road only) may also cause symptoms. Since most roads are higher in the centre and slope toward the edge, running on only one side will cause one leg to always be downhill from the other. Runners who fail to recognize this issue are at risk to develop inflammation of the iliotibial band.


While Iliotibial Band Syndrome pain can be acute, the iliotibial band can be rested, iced, compressed and elevated (RICE) to reduce pain and inflammation followed by stretching. Massage therapy, can offer relief if symptoms arise. Deep tissue work and trigger point therapy are among the techniques used while treating those that suffer from iliotibial band syndrome. Strength exercises for the core and glutes are important to improve pelvic stability and reduce chances for the ITB to return.

The pain from Iliotibial Band Syndrome often starts with inflammation and this takes time to build up, so a lot of people only start to feel the pain after a run. The typical patient will report an increase in mileage and may have increased too quickly, not allowing their body to adjust. Once it starts it is very difficult to calm down. The mistakes many people make are trying to continue running and seeking help too late and/or believing that a foam roller will cure all evils.

We offer treatment for iliotibial bands (ITBs) in Cape Town