ITB syndrome explained

DISTRESS SIGNAL: Tense or stinging sensation in the thigh.

The Iliotibial Band (ITB) is a thick and very tough group of fibres that run along the outside of the thigh. This thick band of fascia extends from the top of the pelvis (the illium), down over the knobbly bone of your thigh to the top of the tibia, on the outside of your knee. Hence the name!!

The main function of this large thick band is to act as a stabiliser during walking or running. In fact, it is crucial for stabilising the knee while running. The first distress signals are often a tense feeling or a tingly-stinging sensation over your thigh, sometimes after activity rather than during. 

However, the pain unfortu-nately will intensify over time. You will be stiff after rest, then easier as the muscle warms, and then the pain increases due to the build-up of inflammation.

This inflammation is caused by friction and rubbing at the hip and the knee as the muscle moves across from behind the femur to the front of the femur during activities that make you bend and extend the hip and the knee.

The pain around the top of the thigh is perhaps more common in women due to the rounded shape of the pelvis; they often notice it more when going up or down stairs or getting out of a car. On the other hand, men and athletes tend to experience the pain at the outside of the knee, making them think they have injured the knee joint.

Pain is usually felt as the foot strikes the ground and is almost always inaccurately blamed on the hip joint but actually the main cause or predisposing factor that causes the development of ITB is having poor foot biomechanics. With every step, the arch of the foot drops and rolls inwards, twisting the ITB and causing friction. Poor footwear only makes matters worse!

The other problems that can contribute to ITB are poor pelvic stability, weak gluteal and/or thigh muscles, over-training the legs, knee problems (particularly if you have difficulty fully straightening your knee), previous surgery at the hip or knee and ‘bow’ legs. 

So what can you do? 

Initially, you can ice, massage and stretch your leg. When stretching your ITB, you may feel a ‘pulling’ sensation over the muscle (don’t worry if you don’t feel it at your sore area). As you gently loosen and stretch the ITB, the tension will begin to diminish.

New taping methods are very effective as they help to soften and encourage the muscle to lengthen and therefore function more accurately.

Addressing other muscle imbalances is essential to help improve your situation. Long term, the only certain way of keeping this syndrome at bay is to resolve your biomechanical issues. This is best analysed using a specialised video and gait analysis system.

If you are unsure which areas are causing you pain or you would like information on how we can help you, please call 952 883 151 or visit

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