What is ITB friction syndrome?


At some point in their career just about every runner will feel a warming on the outside of their knee, turn into a dull ache and eventually – if you don’t do something about it – an excruciating high-voltage pain. If you’ve experienced this first-hand, then chances are you know about ITB friction syndrome.

If not, here’s how it works: your ITB is a long band of fibrous tissue running down the outside of your leg, starting at your hip and finishing just below your knee. Around your knee joint it passes over a bony protrusion – normally this isn’t a problem, but sometimes it rubs against that bone, starting a cycle of inflammation; the more it rubs the more inflamed it gets, the more inflamed it gets the more it rubs – the end result is a dejected trail runner facing a long walk back to the car.

Needless to say, it’s something you want to avoid if at all possible. Fortunately much of the time the cause will be environmental; running on a cambered downhill trail is a great way to do it. But biomechanics and technique frequently play a role too; if you’re slightly knock-kneed or have hips that swing like a supermodel when you run then you’ve got a good chance of giving your ITBs a rev-up at some stage in your life.

If your ITB starts playing up when you’re on the trail, your best bet is to stop, and walk back to civilisation. If you can, throw a cold pack on the site of the pain to try and calm down the inflammation (or jumping in a cold alpine creek works a charm). Once you get home, massage your ITB above the site of the pain using either a tennis ball or a friend. You can also stretch the piriformis (or deep gluteal muscles) that attaches to the ITB to give it a little more slack.

In most cases, the root cause is a lack of pelvic stability caused by a poorly functioning Gluteus Medius (yes, that’s a polite way of saying you have a lazy arse) so it’s well worth asking a good physio to teach you some exercises to help you ‘recruit your glutes’ when you run and consulting a running coach to iron out any technique issues.

— Reproduced from the Summer 2012 edition of NZ Trail Runner Magazine —