Do You Have Unexplained Knee Pain? Maybe You Have ITBS!


Many runners think they have a knee injury when they start noticing swelling and pain on the outside of their knee. Recently I had a consult with a man who had knee pain “out of the blue.” He wasn’t given any answers from a doctor or an MRI regarding the cause of the pain. Once he realized how tight his IT-band was, he started treating it and found that his knee pain started to subside.

What is an IT-band?

IT-band is short for Iliotibial Band, a ligament that runs down the outside of the leg from the hip down to the shin. Its job is to stabilize and move the knee. If your IT band is tight or inflamed you may have Iliotibial Band Syndrome (ITBS). This is one of the most common overuse injuries among runners that can occur when there is continual rubbing of the IT-band over the lateral femoral epicondyle, which leads to the area becoming inflamed.  Also, the TFL (Tensor Fascia Latae) attaches to the IT-band and if it’s overactive it can cause tension throughout the IT-band and lateral knee.

What are the common causes for ITBS?

  • Wearing worn-out/unsupportive shoes
  • Running downhill
  • Overuse/running too many miles per week
  • Your gait pattern/form while running

How can you prevent ITBS?

  • Warm-up! Before you go for a long run, walk at a brisk pace for at least 3-5 minutes.
  • Check your shoes. If you see they’re worn down along the outside of the sole, it may be time to replace them.
  • Try to avoid running on uneven surfaces.
  • Decrease your mileage if you notice any pain along the outside of your knee.
  • Foam roll! Maintenance is key for injury prevention! Do a few dynamic stretches and foam roll prior to a long run.

How do you treat ITBS?

If you start to notice signs of ITBS, rest or decrease the mileage depending on the severity of the pain. If you don’t act quickly with treatment, it can become a chronic problem. Have it checked by a health professional that can assess the area with a manual muscle testing. Does this mean you have to stop exercising? No! Just switch it up. Try biking, rowing or swimming for less impact while that area heals. Also, foam rolling will be extremely helpful in addition to stretching, icing, heating and using a topical ointment like Biofreeze.


Image above from NASM Essentials of Corrective Exercise Training