What Causes Iliotibial Band Syndrome / Runners Knee?

Certain factors may make you more susceptible to developing runners knee or iliotibial band syndrome:

  • A naturally tight or wide IT band
  • Weak hip muscles such as gluteus medius
  • Trigger points within the IT band and gluteal muscles
  • Overpronation
  • Overuse
  • Excessive hill running
  • Running on a cambered surface
  • Leg length difference
  • Most of these factors can be addressed through changes to your training programme, the use of insoles or heel pads and a thorough rehabilitation programme.
  • Iliotibial band friction syndrome may require long-term rehabilitation and frequent Iliotibial band stretches should be maintained even after symptoms cease.


  • This knee pain occurs on the outside of the knee (at or around the lateral epicondyle of the femur).
  • Tightness in the iliotibial band. 
  • Pain normally aggravated by running, particularly downhill.
  • Pain during flexion or extension of the knee, made worse by pressing in at the side of the knee over the sore part.
  • Weakness in hip abduction.
  • Tender trigger points in the gluteal area may also be present.

What can a Sports Injury Professional do?  

  • Perform soft tissue or deep friction massage.
  • Prescribe anti-inflammatory medication such as NSAID’s e.g. Ibuprofen.
  • Use Myofascial release techniques which have been shown to be highly effective.
  • Perform dry-needling techniques.
  • Outline a rehabilitation strategy which may include stretches and exercises to strengthen the hip abductors.
  • Use electrotherapeutic treatment techniques such as TENS or ultrasound to reduce pain and inflammation.
  • In acute or prolonged cases a corticosteroid injection into the site of irritation may provide pain relief.

How can sports massage benefit the rehabilitation of this injury?

  • The aim of sports massage is to release tension in the muscle and fascia and stimulate blood flow.  
  • Massage must not be performed during the acute stage of an injury - usually at least 48 hours after injury. For grade two and three strains, massage may not be suitable for over a week. This is because if there is still bleeding then heat and massage will increase bleeding, not stop it.