Iliotibial Band Syndrome

Iliotibial band syndrome in runners is explained through anatomy, pain mechanisms, common risk factors, assessment, and rehabilitation. Learners are introduced to current evidence showing that ITB pain is more likely related to compression of highly innervated tissue near the lateral femoral epicondyle during about 20-30 degrees of knee flexion, rather than friction from the band rubbing over the bone. The teaching also emphasizes that the IT band is a strong fascial structure and cannot be meaningfully stretched, which challenges common advice such as stretching and foam rolling. Key factors linked with symptoms include sudden increases in training load, hill or downhill running, reduced hip abductor strength, greater hip adduction and medial rotation during running, and increased ITB strain rate. Practical assessment covers subjective history, differential diagnosis, Noble’s compression test, strength testing, and movement analysis. Management is organized into three phases: calming pain and maintaining capacity, progressing hip and lower-limb strength, and restoring impact tolerance before a gradual return to running. The overall aim is to improve confidence in evidence-based assessment and treatment of runners with ITB syndrome.