Summary

• Iliotibial band syndrome (ITBS) is the most common cause of lateral knee pain in runners, related to repetitive friction of the iliotibial band (ITB) sliding over the lateral femoral epicondyle.
• Runners predisposed to this injury are typically in a phase of over-training and often have underlying weakness of the hip abductor muscle.
• In the acute phase, treatment includes activity modification, ice, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroid injection in cases of severe pain or swelling.
• During the sub-acute phase, emphasis is on stretching of the ITB and soft-tissue therapy for any myofascial restrictions.
• The recovery phase focuses on a series of exercises to improve hip abductor strength and integrated movement patterns. The final return to running phase is begun with an every-other-day programme, starting with easy sprints and avoidance of hill training with a gradual increase in frequency and intensity.
• Surgery can be considered in refractory cases.