Illiotibial Band Friction Syndrome at a Glance

For many St. Louis runners, the time has come to lace up your shoes and hit the road running in preparation for a spring marathon or half marathon.  Three or four weeks into their new training program will be a tough time for some of those runners because that period is one of the likeliest for an injury to occur.  And one of the most common of those injuries will be Illiotibial Band Friction Syndrome (IBFS or ITB).

While IBFS is sometimes caused simply by the friction resulting from the the constant bending and straightening of the knee during the running motion, the most common root cause of friction on the illiotibial band is  an increased tilt in the pelvis.  In either case, the friction eventually results in the same localized irritation and inflammation of the illiotibial band.   IBFS-causing hip tilt can be caused by both internal and external geometries.   Internally, anatomical problems such as bowed legs, differences in leg length, excessive pronation (i.e., rolling inward) of the foot and ankle, and weak or tight glute or quad muscles can cause the tilt.  Externally, if a runner repeatedly runs on the same side of a sloped road, hip tilt is almost inevitable.    

What the runner will feel….

  • tightness on the outside of the knee that becomes a burning or stinging sensation when they run;
  • pain on the outside of the knee;
  • a snapping, popping, or "giving" sensation;
  • increased pain when rising from a seated position;
  • pain that subsides when not running;
  • and the need to walk with a stiff leg to relieve the friction.


  • Take a break from the activity that causes the pain, but continue to train in activities that do not.
  • Apply ice packs to the knee for 15-20 minutes, 3-4 times a day.
  • Stretch, foam roll, and massage large dynamic muscle groups such as quads, glutes, and the lateral aspects of the thigh.
  • Seek a health professional if symptoms persist more than 3-4 weeks.

In the future...

  • warm up slowly and replicate the type of movement you will use when running or walking;
  • increase training intensity gradually: no more than 10% each week;
  • avoid repeated running on a banked surface;
  • and visit your local FLEET FEET store to make sure you are wearing appropriate shoes that provide adequate lateral (side-to-side) support.

If you have any further questions, please contact FLEET FEET Head Coach, Brandi Barbre, at or by calling 855-LUV-2-RUN ext. 5.

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