The iliotibial band (ITB) is a thick, strong band of connective tissue that runs along the outside of your leg, extending from the hip down to just below the knee. When this tissue becomes irritated, it can lead to a painful condition known as iliotibial band syndrome (ITBS).
ITBS most commonly causes pain on the outside of the knee, though symptoms can also appear at the hip. This condition occurs more frequently in active and athletic individuals and is seen more often in people assigned female at birth than those assigned male at birth.
What Causes Iliotibial Band Syndrome?
Iliotibial band syndrome is considered an overuse injury, and symptoms usually develop due to a combination of factors. Two of the most common mechanisms include:
Friction, when the ITB repeatedly rubs against bone
Compression, when the tissue remains taut and irritated
Other contributing factors may include excessive foot pronation, sudden increases in training volume or intensity, and altered movement mechanics during exercise or sport.
Common Symptoms of ITB Syndrome
Symptoms often present as an aching or sharp pain on the outside of the knee that worsens with activity. Pain may affect one or both knees and can travel up the outside of the thigh toward the hip. Some individuals also report clicking or popping sensations at the knee.
Pain often increases during activities such as walking or running downhill, where the ITB experiences greater tension and compression.
How Physical Therapy Helps
At Breathe In Motion, treatment for iliotibial band syndrome focuses on addressing the root cause of symptoms. Physical therapy may include:
Education on ITB syndrome and contributing factors
Manual therapy- including scraping, cupping, or dry needling– to reduce tension and improve tissue mobility
Targeted exercises to improve strength, stability, and movement mechanics
A personalized home exercise program to support long-term recovery
Our goal is to reduce pain, restore efficient movement, and help you return to activity with confidence.
