If you’re a runner and you’ve been feeling a sharp, nagging pain on the outside of your knee – especially during or after a run – you might be dealing with Iliotibial Band Syndrome, or ITB Syndrome. It’s one of the most common overuse injuries in runners, and the good news is: with the right approach, it’s treatable and preventable.
What Is ITB Syndrome?
The iliotibial band is a thick band of connective tissue that runs from your hip down the outside of your thigh and attaches just below your knee. Its job is to help stabilize the knee and hip during movement. With repetitive motion – like running – the ITB can become irritated, especially as it rubs over the bony structures near the knee. This is what causes that outer-knee pain.
Reference: (Fairclough et al., 2006) challenged the “friction” theory and suggested compression of underlying fat and tissue plays a role, but the pain location and pattern remain consistent among runners.
Why It Happens
ITB Syndrome often stems from:
- A sudden increase in mileage or intensity
- Running on uneven surfaces or banked roads
- Weakness in the glutes or hip stabilisers
- Poor control through the knee and pelvis during stance phase
- Old or worn-out shoes that no longer provide support
Key Rehab Exercises
Start with low-load, low-irritation exercises and build up:
1. Side-Lying Hip Abductions
✅ Targets: Glute med
3 sets of 10-12 reps (slow tempo)
2. Step-Downs or Lateral Step-Downs
✅ Focus on control and keeping the knee tracking straight
2–3 sets of 6–8 per leg
3. Single-Leg Glute Bridge
✅ Builds hip control and pelvic stability
2 sets of 10 per side
4. Copenhagen Side Planks (Short Lever to Start)
✅ Targets lateral core and hip
Hold 15–30 sec each side x 2
These strengthen the muscles that support your pelvis and knee, helping reduce the strain on the ITB.
Return to Running: General Guide
When symptoms settle to a mild level (1–2/10 discomfort), you can start a gradual return:
Week 1–2
- Walk-run: 1 min run / 2 min walk x 5 rounds
- 2–3 days/week, flat surfaces
Week 3–4
- Increase to 3–5 min running intervals
- Total time ≤20 min
Week 5–6
- Continuous runs of 15–20 min
- Gradually add 5 minutes each week
Tip: Only increase one variable at a time (distance, speed, or frequency).
Running Tips to Keep You Moving
✅ Warm-up properly with dynamic movements (leg swings, walking lunges)
✅ Mix your surfaces – too much cambered road running can irritate the ITB
✅ Watch your cadence – aim for ~170–180 steps per minute
✅ Replace worn-out shoes every 500–800km
✅ Strength train 2x/week – running is a skill and a strength game
Final Thoughts
ITB syndrome can feel frustrating, especially when it stops you from doing what you love. But with the right plan – one that combines load management, strength rehab, and smart running – you can get back to running pain-free and stronger than before.
If you’re a runner in the Ipswich area and need help navigating ITB pain, we’d love to help. Our Back 2 Your Best Rehab Program offers expert assessment, individualized strength programming, and return-to-run coaching.
