Iliotibial Band

The iliotibial band (ITB) is a long reinforced band of fascia that runs the length of the outside of the thigh. It provides support at the knee and is an attachment point for various muscles of the pelvis.

Iliotibial band contracture is a shortening or thickening of the ITB.

Iliotibial band friction syndrome is inflammation and pain where the ITB crosses the side of the knee.


Iliotibial band contracture

  • Activities or occupations that place the knee and hip in flexion allowing the muscles which insert into the ITB to shorten. For example – horseback riding, cycling, prolonged sitting.
  • Postural imbalances such as anterior pelvic tilt, hyperlordosis and muscle imbalances.
  • Prolonged wheelchair use or bed rest

Iliotibial friction syndrome

  • Prolonged repetitive activities where the knee is flexed such as running and cycling.


  • Gradual onset of pain which gets worse with activity. Pain is felt along the outside of the thigh and knee.
  • Shortening of the ITB
  • Thickening of the ITB, and adhesions and scar tissue can be found along the ITB
  • Low back pain
  • Inflammation at the knee is common in friction syndrome.
  • Trochanteric bursitis may develop as a secondary condition

Contributing factors

  • Tight pelvic muscles, including the gluteal muscles and the tensor fascia lata.
  • Running in one direction on a track that is sloped or banked
  • Flat feet or wearing shoes with poor arch support.
  • Poor stretching techniques
  • Sedentary lifestyle

How can Massage Therapy help?

Treatment for Iliotibial band contracture/friction syndrome will include massage of the gluteal and thigh muscles, fascial techniques to reduce the contracture and restrictions, frictions to remove adhesions that may be present. Patient eduacation is another important element of treatment. We will teach you proper stretching techniques. We will work with you to determine the exact cause of the the condition and determine how you can modify your activities to avoid future re-occurances.