Knee Pain in Runners (Iliotibial Band Friction Syndrome)

Q: Why does the outside of my knee begin to hurt in the middle of my run?

A: Pain at the outside portion of the knee during running may be due to iliotibial band friction syndrome.  The iliotibial band (ITB) is a thick band of tissue on the outside of the thigh, extending from the hip to just below the knee.  It stabilizes the knee during running, and can become inflamed due to the knee’s repetitive motion.  The pain generally occurs during or after activity, and the area may become swollen and tender to the touch.

ITB syndrome may be caused by:

  • a change in training habits (e.g., increasing mileage too quickly)
  • running on a banked surface
  • structural abnormalities (e.g., flat feet, bow legs, uneven leg length)
  • muscle imbalances

Treatment generally involves rest from the aggravating activity, ice to reduce swelling, stretching the ITB, and strengthening the hip muscles.  It is important to consult a physical therapist to determine what is causing the syndrome, and to learn proper strengthening and stretching exercises.