Iliotibial Band Friction Syndrome involves the compression of the iliotibial band (ITB) on the lateral femoral condyle (the bony prominence on the outside of the knee).

This is primarily due to suboptimal hip control (usually genu or dynamic valgus or ‘knock knees’), and associated tight outer hip/leg muscles. The compression causes friction between the ITB and the condyle, which causes subsequent inflammation and pain.


Client will report pain on the outside (lateral) knee, and/or outer thigh pain. The client may also report a ‘snapping’ type feeling with certain activities. Pain can be an ache, or occasionally sharp in nature.


  • Activities that flare up this pain are usually running (especially a dramatic increase in distance or downhill running) and stairs.
  • Local swelling and tenderness over the outer knee.
  • Tightness in quads and ITB, and commonly outer hip/glutes.


  • A period of active rest – load management to let the pain settle. This often involves decreasing your running distance/load initially.
  • Release of tight outer leg/hip musculature – this involves dry needling or deep tissue massage of the ITB, TFL, quads, glutes (depending on what is tight for the individual client).
  • Correcting lower limb posture and biomechanics – and often this involves strengthening the hip external rotators and abductors (glutes).
  • Advice regarding anti-inflammatories, and home releases (with the trigger ball & foam roller).

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