ITB Friction Syndrome Treatment Melbourne: Best Physiotherapy for IT Band Pain

Physiotherapy for ITB friction syndrome

If you’ve ever experienced a sharp pain on the outer side of your knee, particularly during or after running, you may be dealing with Iliotibial Band Friction Syndrome (ITBFS). This common overuse injury primarily affects runners, cyclists, and athletes who engage in repetitive knee movements (Ellis et al, 2007). ITB Friction Syndrome can be frustrating and persistent, often interfering with training, competitions, or even daily activities.

Understanding the causes, symptoms, and treatment options for ITB Friction Syndrome is crucial in effectively managing the condition. Without proper intervention, ITBFS can lead to prolonged discomfort and limit your ability to perform physical activities. At Keilor Road Physiotherapy, we specialise in diagnosing and treating ITBFS using personalised rehabilitation programs to reduce pain, correct movement patterns, and prevent recurrence.

What is ITB friction syndrome?

Iliotibial Band Friction Syndrome (ITBFS) occurs when the iliotibial band (ITB), a thick connective tissue running along the outer thigh from the hip to the shin, repeatedly rubs against the lateral femoral epicondyle, which is the bony outer part of the knee. This friction leads to inflammation and irritation of the band, resulting in pain, particularly during activities involving repetitive knee bending, such as running, cycling, or walking downhill.

The iliotibial band plays a crucial role in stabilising the knee joint, especially when moving from extension to flexion (straight to bent). When functioning correctly, it assists in lateral knee stabilisation. However, when excessively tight or under stress from biomechanical imbalances, the ITB can become a significant source of discomfort, particularly for athletes who frequently perform high-impact movements.

ITB Friction Syndrome is one of the most common causes of lateral knee pain in runners, often referred to as "runner’s knee," although it differs from patellofemoral pain syndrome, which affects the front of the knee. It also frequently affects cyclists, hikers, and athletes in sports that require repetitive knee motion.

Best ITB pain treatment Melbourne.

ITB tightness causes and risk factors

There are multiple factors that can contribute to the development of ITB Friction Syndrome. One of the most common causes is overuse and repetitive stress, particularly in endurance sports. Athletes who train excessively without allowing for sufficient recovery are at higher risk.

Biomechanical issues also play a significant role in ITBFS development. Poor hip and gluteal muscle strength can cause the knee to collapse inward while running, increasing friction between the ITB and the femur. Additionally, tight hip flexors and quadriceps muscles can place additional tension on the IT band, making it more prone to irritation.

Foot mechanics are another contributing factor. Overpronation, where the foot rolls inward excessively while running, can alter the alignment of the lower limb, further increasing stress on the ITB. Similarly, leg length discrepancies can cause an imbalance in weight distribution, leading to excessive tension on one side.

Training errors, such as suddenly increasing running mileage or intensity, frequently running on uneven surfaces, or failing to incorporate adequate warm-up and stretching routines, can further exacerbate the condition. Wearing worn-out or unsupportive running shoes can also alter biomechanics, making ITBFS more likely to develop.

Why does my IT band hurt when I run?

The most characteristic symptom of ITB Friction Syndrome is pain on the outer side of the knee, typically worsening during activities that involve repetitive knee flexion and extension, such as running or cycling. In many cases, pain begins as a mild discomfort but progressively worsens, making it difficult to continue exercising (Fredericson et al., 2006).

Many individuals describe a sharp, burning, or aching pain near the knee joint, often located just above the lateral epicondyle of the femur. This pain may be accompanied by tenderness, swelling, or a snapping sensation as the IT band rubs over the bony prominence.

Symptoms often worsen with prolonged activity and may become particularly noticeable when running downhill, climbing stairs, or walking long distances. In severe cases, pain persists even during rest, significantly impacting daily activities and athletic performance (van der Worp et al., 2012).

If left untreated, ITBFS can become chronic, making it harder to resolve with conservative treatment. Recognizing symptoms early and seeking professional intervention can help prevent long-term complications.

How to diagnose ITB friction syndrome

Diagnosing ITB Friction Syndrome typically involves a clinical assessment by a physiotherapist. At Keilor Road Physiotherapy, we begin with a detailed medical history to understand the onset, progression, and triggers of your pain.

A physical examination follows, focusing on knee alignment, IT band tightness, muscle strength, and flexibility. We perform specific movement tests, such as the Ober’s test and Noble’s compression test, which help confirm ITB involvement.

Additionally, gait analysis and biomechanical assessments may be conducted to identify contributing factors such as poor running form, excessive pronation, or muscular imbalances. In cases where another knee pathology is suspected, imaging tests such as ultrasound or MRI may be recommended to rule out other potential causes of knee pain.

Best treatments for IT band friction syndrome

Successful treatment of ITBFS requires a combination of pain management, rehabilitation exercises, and biomechanical corrections to prevent recurrence.

Physiotherapy Treatment

At Keilor Road Physiotherapy, we design individualised rehabilitation programs that address the root cause of ITBFS. Our treatment approach includes hands-on therapy, strength training, stretching, and movement retraining to reduce pain and restore function.

Manual therapy techniques, such as soft tissue release, deep tissue massage, and dry needling, help alleviate muscle tightness and improve flexibility. We also incorporate myofascial release techniques to reduce tension in the IT band and surrounding structures.

Strengthening exercises focus on improving hip, gluteal, and core stability, which are crucial for preventing excessive strain on the IT band. Targeted exercises for the dynamic stabilisers of the hip help restore muscle balance and knee control.

Stretching and mobility work are also essential components of rehabilitation. IT band stretches, quadriceps and hamstring flexibility exercises, and foam rolling techniques are incorporated to prevent excessive tightness.

For runners and athletes, running gait analysis and movement retraining are key aspects of rehabilitation. Our physiotherapists assess stride patterns, foot mechanics, and movement efficiency, making necessary adjustments to reduce stress on the ITB.

ITB friction syndrome treatment

How to prevent ITB friction syndrome in runners

Preventing ITB Friction Syndrome requires a proactive approach to training, strength development, and mobility work. Gradually increasing running or cycling distance, rather than making sudden changes, can help minimise excessive strain (Fredericson et al., 2006). Proper strength training for the hips, glutes, and core ensures the knee remains stable during movement.

Stretching routines should be incorporated before and after exercise, focusing on the IT band, quadriceps, hamstrings, and hip flexors. Using foam rollers and massage techniques can help maintain flexibility and prevent excessive tightness.

Choosing the right footwear for running and sports is also essential. Wearing shoes with proper arch support and cushioning reduces biomechanical stress. If needed, custom orthotics may be recommended for better alignment and support.

When advanced treatment for ITB pain might be needed?

In most cases, ITB Friction Syndrome responds well to physiotherapy and conservative management. However, there are instances where advanced treatment options may be required. If the pain persists despite months of physiotherapy and rehabilitation exercises, further interventions may be necessary.

Corticosteroid Injections

For individuals experiencing severe inflammation and persistent pain that does not improve with manual therapy or exercises, corticosteroid injections may be recommended. These injections help reduce inflammation around the IT band and provide temporary relief, allowing for better participation in rehabilitation. However, they are not a long-term solution and should be used cautiously, as excessive use can weaken surrounding tissues.

Shockwave Therapy

Shockwave therapy is a non-invasive treatment that uses sound waves to stimulate tissue healing and break down scar tissue. This can be particularly beneficial for chronic cases where the IT band remains persistently tight and inflamed.

Platelet-Rich Plasma (PRP) Injections

PRP injections involve using a concentration of the patient’s own platelets to promote healing and reduce inflammation. While still under research, PRP therapy has shown promise in accelerating tissue recovery and reducing chronic pain in tendon and soft tissue injuries.

Surgical Intervention (Rare Cases)

Surgery is rarely needed for ITB Friction Syndrome, but in severe, treatment-resistant cases, surgical release of the iliotibial band may be considered. This procedure, known as IT band release surgery, involves lengthening or removing part of the IT band to reduce friction over the lateral femoral epicondyle. Surgery is usually only recommended when all conservative measures have failed and the individual continues to experience debilitating pain.

If you’re experiencing persistent knee pain despite conservative treatment, it’s important to discuss alternative options with your physiotherapist to determine the most appropriate course of action.

Why choose Keilor Road Physiotherapy for your ITB treatment?

At Keilor Road Physiotherapy, we take a comprehensive and evidence-based approach to treating ITB Friction Syndrome. Our hands-on therapy techniques, strength-based rehabilitation programs, and running gait analysis provide patients with a tailored recovery plan designed for long-term success.

Our onsite rehabilitation studio ensures that patients receive individualised, guided exercise programs, allowing them to strengthen key muscle groups effectively. Whether you're an elite athlete or a recreational runner, we help you return to pain-free movement with confidence.

How to relieve knee pain from ITB syndrome

ITB Friction Syndrome is a common but manageable condition with early intervention, proper rehabilitation, and preventative care. If you’re struggling with ITB pain, don’t let it impact your training or lifestyle. Contact Keilor Road Physiotherapy today to book an appointment and receive expert care tailored to your recovery needs.

References

1. Ellis, R., Hing, W., & Reid, D. (2007). Iliotibial band friction syndrome--a systematic review. Manual therapy, 12(3), 200–208. https://doi.org/10.1016/j.math.2006.08.004

2. Fredericson, M., & Weir, A. (2006). Practical management of iliotibial band friction syndrome in runners. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 16(3), 261–268. https://doi.org/10.1097/00042752-200605000-00013

3. van der Worp, M. P., van der Horst, N., de Wijer, A., Backx, F. J., & Nijhuis-van der Sanden, M. W. (2012). Iliotibial band syndrome in runners: a systematic review. Sports medicine (Auckland, N.Z.), 42(11), 969–992. https://doi.org/10.2165/11635400-000000000-00000

John Keller