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9 Natural Solutions For ITB Syndrome in Runners

ITB Syndrome (ilio-tibial band syndrome or pain) is well known amongst runners and to date about 2,010,000 results can be found on google on self help. Much of the advice found online is more of the same with no real clear effective way to treat it. Many patients I know are running the London Marathon this year, along with the hours of dedicated training and milage needs to be a good routine on self care, whether it is sports massage, osteopathy, stretching or even to mix it up with some Tai Chi, Yoga or Qi Gong.

As marathon runners will find out or know from experience, they run too much too soon. Increasing milage without enough rest and self care can lead to overuse injuries like ITB Syndrome.

In this blog post, discover some more ways in how you can overcome this condition with some natural cures.

What is ITB syndrome?

ITB syndrome is where friction occurs of the iliotibial tendon and or bursa underneath the tendon itself outside of the knee, or less commonly at the hip (greater trochanter). It is essentially an overuse injury that occurs with repetitive knee flexion and extension, it can cause irritation and inflammation also due to repetitive loading.

The primary function of the ITB is to control and decelerate the inward movement of the thigh when the heel strikes the ground. The ITB is most commonly associated with knee pain however it is also involved in the development of “snapping hip” and in greater trochanteric bursitis which is in the hip.

This condition is also commonly seen in many other sports like football, cycling, tennis and those who train in the gym.

That said, with ITB syndrome itself, is it necessary the iliotibial bands fault?

Not really.

Looking at it from an Osteopathic perspective I would want to assess the whole body to understand why the ITB is being irritated.

ITB syndrome osteopathy anatomy

ITB Syndrome Symptoms

The easiest way to tell if you have ITB syndrome is to bend your knee to 45 degrees. If you experience pain on the outside of the knee when slightly bending your knee, it can be a sign this could be the case.

Other common signs of ITB syndrome include:

  • Pain and tenderness along the outside of the knee and along the ITB itself.
  • The pain will start at the beginning of exercise but may reduce after a warm up.
  • Pain will get worse and eventually prevent the person from continuing to exercise.
  • The pain is made worse going up and down stairs or hills.
  • Pain that is felt when the foot strikes the ground.

Natural Solutions To ITB Syndrome

  1. ICE Treatment – First things first, try Ice (not a hot water bottle) applied to the outside of the affected knee for 10 minute intervals. For a 2-3 days try every 1-2 hour intervals of 10 minutes. Many underestimate the power of ice, in cases of inflammation or overuse, using ice i.e. a bag of frozen peas can help reduce the pain and inflammation.
  2. Warm up with walking – As a warm up, try walking first as a way of preparing the body for exercise, especially in the legs.
  3. Rest – Now to tell runners to rest is often times open to disaster. Resting completely will of course be the best solution and the condition will improve when the activity is avoided. For many I will suggest modifying the type of exercise so the patient does not lose fitness.
  4. Stretching – Stretching is often times the best solution. The downside is, many will stretch muscles that do not need stretching. There is a problem with that as it may further exacerbate the problem by further promoting imbalances in the length tension relationships of the body. Having body balance is important.
  5. Gait Analysis – The modification of a runner’s actual running style is actually quite ridiculous — aka his or her gait — The gait or the act of running is in fact a reflex. The way one runs may be due to the biomechanics of the body. Gait analysis is a common and very helpful way to understand how the body is moving when running but I do not always agree that an over pronation of the foot is an orthotic deficiency! By all means get an assessment, but find out causes rather than trying to find ways of patching up the symptoms.
  6. Osteopathy – The goals of Osteopathy are to assess and treat the body as a whole. Strengthening and stretching exercises may be included to targeted areas.
  7. Foam Rolling – Foam rolling is a very common modality for attempting to release iliotibial band. However, it can actually irritate the inflamed tendon itself causing more harm than good! What may be a better alternative is the stretch and use rollers, balls and tools to work into the glutes, hips and hip flexors.
  8. Check Your Footwear – I would advise patients to ensure that they are not training in old pairs of shoes. I personally advocate the use of vibram fivefingers however, there are other brands of barefoot shoes that are minimal and offer a larger toe box for better toe spread and sensory feedback.
  9. Specific Changes for Cyclists & Runners – Triathletes, spinning enthusiasts and road cyclists can often benefit from visiting a cycling store to have their bikes custom fitted for them. Spinning lovers will need to ensure their seats are set correctly for their height. Runners can benefit from running on flat surfaces with softer surfaces. I would avoid hill running intervals until your ITB inflammation and pain has gone but to not return to soon.


ITB is an annoying condition as a result of pain and inflammation of the iliotibial band tendon that can rub and cause friction at the outside of the knee. The friction can also occur at the hip joint as the fascia is an extension from the TFL muscle and the glute max above the hip joint.

ITBS running York

I would suggest you listen to your body and if you do start to get pain at the outside of the knee, it may be ITB syndrome but it can also be many other reasons so it is best you get assessed by an Osteopath first.

If you run, cycle or play sports, there is nothing more important than prevention. Getting your whole body assessed like I do when performing a Kinetic Chain Assessment, will lead to much better results long term and a corrective exercise program can commence.

I hope that helps, feel free to leave your feedback in the comments below and be sure to follow me on Instagram, facebook and twitter.



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