Chronic Injuries: 1: ITB Syndrome

“The hip bone’s connected to the knee bone…”


We all remember signing along as a child, but do you really understand the connections between key areas of your body?

The connective component in our body is fascia, which serves to protect, support and encase our entire system from muscles and organs to the nervous system and blood vessels. The importance of fascia is that without it we would not be able to stand, move or function. Fascia encases every muscle, ligament, tendon, everything; to provide glide between them, and thick bands of it loop around out body to provide what we refer to as ‘tensegrity’ (tension integrity!) which means nothing in our body is attached to or rubbing on other structures; it is all literally hung in position by the stretchy but strong fascia which attaches into our bones and skin.

I could talk for ages about the functions of different fascia! But in this series of articles I would like to take a little time to explore some of the common syndromes and conditions experienced and how understanding the pattern of the tension, the tissues involved and how they behave and getting the correct treatment can be simple.

By Remedial Massage Therapist , Liverpool Street, Amy.

iliotibial-band-syndrome- Sydney- physioWhat is ITB Syndrome?

The Iliotibial Band (ITB) is a strong band of fascia that supports the femur from hip to knee and is part of the Spiral band of fascia that loops around our feet and around our upper body.


ITB Syndrome is one of the most common causes for lateral leg, hip and knee pain in runners and athletes. The ITB gets tight during running, or with similar motions, as it rubs against the head of the femur back and forth and the knee flexes and extends causing a stretching and rubbing of the tissue which can become tight and inflamed.


Repeated actions can cause swelling to remain in the knee, or thicker scar tissue to develop around the lateral knee and ITB. The pain may intensify over time or be felt during activity, commonly as the foot strikes the ground if running on a hard surface.


What’s the treatment?

Foam rollering, R.I.C.E. and stretching can ease the symptoms of an acute (sudden) bout of ITB Syndrome.ITB stretch Physio Sydney


When you have suffered with tightness in the area for longer term (over 2 weeks) then further treatment may be required.

In order to provide release, a skilled Massage Therapist or Physiotherapist will need to determine the pattern of the tension to balance the body. Where there is tightness and strength there will normally be slack and weakness in corresponding areas. By assessing your posture and using MFR techniques following known pathways, your therapist can work to resolve movement patterned tension and rotational compensations by drawing flexible fibrous tissues to restricted areas following fascia pathways. Directional pressure can then be used to continue to open deeper into the layers of connective tissues to free deep and chronic restrictive tension.

MFR is also often an effective treatment for migraines, IBS, Endometriosis, breathing difficulties and short muscles.


A Tight ITB or ITB syndrome is frequently partnered with Shin Splints, Plantar Fasciitis and/or Piriformis syndrome. Read our next Chapters to learn more about how these injuries are connected and self preventative methods to apply yourself!