Knee - ITB Friction Syndrome (ITBFS)

ITB friction syndrome has many common features to patellofemoral pain, and may occur simultaneously.  

(Please see Patellofemoral Knee Pain tab for more information)

Signs & Symptoms

The most common symptom of ITBFS is pain occurs on the outer side of the knee where the taut ITB rubs over bony outer edge of the knee, and the sensitive bursae (sacks of fluid) that are designed to reduce friction in these spots.

The pain typically comes and goes as you bend past a certain degree of knee bend, and is directly related to activity.  Often it occurs due to sudden increase in training, running downhill, orswapping from cycling to running (such as triathletes).


ITBFS can be caused by numerous factors, which can be assessed by a physiotherapist, often it is due to a combination of these:

>     Muscular tightness, most commonly of the quadriceps

>     Poor hip control, causing the knee to roll inwards

>     Pronated (flat) feet, causing the knee to roll inwards

>      Previous ankle sprain

>     Poor running technique


A Physio or GP can usually diagnose ITB Friction Syndrome easily from your symptoms and examination.  X rays and other scans are not necessary.

Physiotherapy Treatment

Initial treatment requires rest from strenuous exercise, avoiding painful activities, ice and possibly anti-inflammatories.  Treatment focuses on rectifying the relevant factors for each individual patient.  

It is likely to include some of the following:

>     Release of tight muscles with massage and/or dry needling

>     Stretches for the calves, quadriceps, hamstrings, hip flexors and


>     Taping

>     Exercises for improving biomechanics and muscle control