Everything You Need to Know About Iliotibial Band Syndrome
What is Iliotibial Band Syndrome?
Iliotibial Band Syndrome (ITBS) is a condition where the iliotibial band, a thick band of connective tissue running down the outside of your thigh, becomes tight and irritated, causing pain on the outer part of the knee. It’s most common in runners, cyclists, and people who do repetitive leg movements.
An analogy…
Imagine a piece of rope constantly rubbing over a metal pole. Eventually, it frays or heats up. That’s what happens when the iliotibial band rubs against the outside of your thigh bone near the knee, leading to irritation and inflammation.
What are other names that iliotibial band syndrome can be called?
- Iliotibial Syndrome
- ITB Syndrome
- Runner’s Knee (when referring to pain on the outer side)
- Iliotibial Band Friction Syndrome
What causes iliotibial band syndrome?
- Overuse
- Tight or weak hip muscles
- Poor foot or knee alignment
- Running on uneven surfaces
- Sudden increase in training intensity or distance
What are the signs and symptoms of iliotibial band syndrome?
- Sharp or burning pain on the outer side of the knee
- Pain worsens with running, especially downhill or long distances
- Tenderness or tightness along the outer thigh
- Pain that starts during a workout and eases with rest
- Clicking or snapping sensation on the outside of the knee
- Tight hips or glutes may also be present
What tests are used to diagnose iliotibial band syndrome?
Ober’s Test: Assesses IT band tightness when the leg is lowered from the side.
Noble’s Compression Test: Reproduces pain when pressure is applied over the ITB near the knee during movement.
Functional assessment: Evaluates hip/knee control during activities like squatting or running.
How long does iliotibial band syndrome take to heal?
Mild cases may resolve in 2 to 4 weeks with rest and rehab. Moderate to severe cases may take 6 to 12 weeks or longer. If ignored or poorly managed, it can become chronic and take months to fully settle.
How does iliotibial band syndrome happen?
- Weak glutes or hip stabilisers
- Tight IT band or TFL (tensor fascia lata)
- Poor running technique or excessive mileage
- Wearing worn-out shoes or poor footwear
- Imbalances between left and right legs
What treatment can help iliotibial band syndrome?
- Rest or reduce aggravating activity (especially running or cycling)
- Ice the outside of the knee
- Manual therapy (massage, dry needling, and foam rolling)
- Stretching the IT band, glutes, and hip flexors
- Strength training for glutes, hips, and core
- Shockwave therapy or corticosteroid injections
What exercises or stretches can I do for iliotibial band syndrome?
- Side-lying leg lifts
- Bridges with band resistance
- Foam rolling the outer thigh (IT band and quads)
- IT band stretch (cross one leg behind the other and lean sideways)
- Standing or lying glute stretches
- Clamshells with a resistance band
What products can help with iliotibial band syndrome?
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A hip flexor strain happens when one of the muscles at the front of your hip, mainly the iliopsoas or rectus femoris, gets overstretched or torn. It’s a common injury in sports that involve kicking, sprinting, or sudden movements, causing pain at the front of the hip or groin.
An analogy…
Think of the hip flexor muscles like strong elastic bands that lift your knee toward your chest. If they are stretched too quickly or too far, they can tear like a snapping rubber band.
What are other names that a hip flexor strain can be called?
Hip Flexor Injury, Iliopsoas Strain, Psoas Strain, Hip Flexor Tear, Strained Iliopsoas Muscle, Torn Iliopsoas Muscle, Pulled Hip Flexor
What causes a hip flexor strain?
The hip flexors are a group of muscles that help you lift your thigh toward your body. A strain happens when the muscle fibres are overloaded, usually from a sudden burst of force or a rapid stretch beyond their limit. This causes small (or large) tears in the muscle or its tendon near the pelvis.
What are the signs and symptoms of a hip flexor strain?
- Sharp pain at the front of the hip or groin area
- Tenderness when pressing the hip flexor muscles
- Pain with lifting the knee, sprinting, kicking, or climbing stairs
- Stiffness or weakness in the hip, especially when bending forward
- Swelling or bruising in the front of the hip
- Pain when stretching the hip backward
What tests are used to diagnose a hip flexor strain?
Palpation: Feeling for tenderness in the front of the hip
Resisted hip flexion test: Pain when lifting the knee against resistance
Stretching tests: Extending the hip backward reproduces symptoms
How long does a hip flexor strain take to heal?
Grade 1 (mild) strains often heal in 1 to 2 weeks. Grade 2 (moderate) strains usually take 3 to 6 weeks. Grade 3 (severe) strains (significant tearing) can take 8 to 12 weeks or more to fully recover.
How does a hip flexor strain happen?
- Sudden sprinting or kicking movements
- Explosive acceleration or direction changes
- Tight hip flexor muscles
- Poor warm-up or muscle preparation
- Weak glutes and core, causing the hip flexors to overwork
- Fatigue or previous hip injuries increasing the risk
What treatment can help a hip flexor strain?
- Relative rest from aggravating activities early on
- Ice application for the first 48–72 hours to control swelling
- Manual therapy (massage, dry needling, and stretching)
- Progressive strengthening and controlled stretching of the hip flexors
- Postural retraining and core strengthening
- Gradual return to running, kicking, and sport-specific drills
What exercises or stretches can I do for a hip flexor strain?
- Isometric hip flexor holds
- Glute and core strengthening exercises
- Gentle hip flexor stretches
- Straight leg raises to rebuild control
What products can help with a hip flexor strain?