How to Fight Knee Pain for Runners

Injuries or pain to the knees are one of the most common complaints for runners regardless of age or gender. Iliotibial Band Syndrome (ITBS) constitutes one of the main reasons for knee pain amongst runners. In fact, it is the second most common injury amongst runners, and studies show that approximately half of all runners will be injured during their training year. That means about one-quarter of all runners will experience ITBS in a given year.

The iliotibial band is a thick band that extends from outside the pelvis, over the hip, and inserts just behind the knee. The band is responsible for stabilizing the knee during activity. The constant rubbing across the femur, though, can cause the band to become inflamed. ITBS symptoms vary, but common ones are burning or stinging sensation above the knee joint, swelling of the ITB area, and stinging along the length of the ITB.

Treatment of iliotibial band syndrome often takes a three step approach. Runners can achieve relief for knee pain with this approach. Research has shown that the iliotibial band syndrome has increased greatly over the past decade, and many researchers believe that our stretching-only approach to treatment could be the culprit.


Is it ITBS?

Diagnosing any sort of pain is best left to a doctor, but if the pain is not crippling, there are often a few ways to determine what it is. As a general rule of thumb, any pain on the outside of the knee is almost always ITBS. There are other conditions that could cause pain on the outside of the knee, but they are much less common.

If the pain is directly on the kneecap, it might be something else. It might be patellofemoral pain or “runner’s knee”. Runner’s knee should be treated differently than ITBS.


Pain Management

The first step of treatment involves treating the pain and inflammation that occurs with ITBS. Before any other strengthening or conditioning can begin, the band must be allowed to heal. Topical anti-inflammatories, rest, ice, and Non-steroidal anti-inflammatory drugs (NSAIDs) are all useful at this stage. In some more severe cases, a doctor might administer a corticosteroid injection.


Foam Rolling or Massage

The next step in the process is stretching the band. Massage is an effective tool at this step. If you do not have access to a massage, you can try a foam roller or massaging the band yourself. In the past, this was often the last step of treatment. Strengthening is a new consideration, though.



For the final step, you will begin doing exercises that lengthen and strengthen the iliotibial band. These exercises are popular amongst runners to recover from ITBS and attempt to prevent it in the future. In the past, strengthening was left out of the recovery process, but recent research has shown that weakness in the hips and glutes is often the cause of problems. Strengthening the band and the muscles responsible for running can help mitigate the pain. Injury prevention can help ensure this does not happen again.


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