How long does ITB friction syndrome take to heal?

Most people improve in 6–12 weeks with physiotherapy. Full recovery and resilience building may take 3–6 months, especially for runners training at higher loads.

Can I keep running with ITB syndrome?

You may need to reduce mileage or avoid aggravating runs early on, but most people can continue modified running while strengthening and retraining their technique.

Is foam rolling enough to fix ITB syndrome?

Foam rolling may reduce tightness, but on its own it won’t solve the problem. Strengthening hips and glutes, correcting biomechanics, and progressive rehab are essential.

What happens if I ignore ITB syndrome?

Ignoring ITB pain can make it chronic and more difficult to treat. You may also develop compensations that cause further injuries in the hip, knee, or ankle.

72) Conquer ITB Friction Syndrome: The Complete Physiotherapy Guide to Pain-Free Running

ITB friction syndrome is a common overuse injury causing sharp pain on the outside of the knee, often sidelining runners and active Aussies. The good news? With tailored physiotherapy — from hands-on care to strengthening and running technique — recovery is very achievable. Stick with us for expert advice, real stories, and proven tips

Don’t Let Knee Pain Stop You

Whether you’re training for your first half marathon, hitting the local trails, or just enjoying weekend jogs, ITB friction syndrome can feel like the ultimate setback. But it doesn’t have to be the end of your running story. This blog offers a step-by-step guide on recovery, prevention, and resilience — so you can get back to running stronger and smarter.

What is ITB Friction Syndrome?

The iliotibial band (ITB) is a thick strip of connective tissue running from the hip down to the shin, helping stabilise your knee. ITB friction syndrome occurs when repetitive movement (like running or cycling) causes the ITB to rub against the outside of the knee joint, leading to irritation and pain.

Common Symptoms

Sharp or burning pain on the outside of the knee
Pain that worsens with running, especially downhill or after 10–20 minutes
Tenderness over the lateral knee joint
Occasional clicking or snapping sensations
Relief when resting, but quick flare when resuming activity

Who Gets It?

Long-distance runners (especially those increasing mileage too quickly)
Cyclists, hikers, and athletes doing repetitive leg movements
People with poor hip strength or biomechanics
Those running mostly on cambered roads or uneven surfaces

Why Does ITB Friction Syndrome Happen?

The main issue is overload plus poor biomechanics. Contributing factors include:

Weak glute and hip muscles (causing poor control of thigh alignment)
Excessive mileage or sudden training spikes
Downhill running — increases knee flexion angles where ITB is compressed
Poor footwear or old shoes lacking support
Running form issues — overstriding, knee collapsing inward
Tight muscles around hips and thighs

If your pain is closer to the knee cap, this could be linked to the ITB however due to knee cap maltracking. Read more HERE to understand this injury.

Why Physiotherapy Works Best

Unlike rest or anti-inflammatories (which only treat symptoms), physiotherapy tackles the root cause. It focuses on:

Relieving immediate pain and inflammation
Correcting biomechanics
Strengthening hip and glute muscles
Improving running technique
Building long-term resilience so pain doesn’t return

Step-by-Step Physiotherapy Management

1. Assessment

A physio will take a detailed history, assess your running style, test hip/knee strength, flexibility, and look for movement dysfunctions.

2. Early Pain Relief

Relative rest (short break from aggravating runs)
Ice or cold therapy post-exercise
Soft tissue release of ITB, quads, glutes
Taping or strapping for temporary pain reduction
Gentle stretches for lateral thigh and hips

3. Strengthening Program

This is the core of recovery. Exercises often include:

Side-lying leg raises and clams
Hip thrusts and bridges
Single-leg squats and step-downs
Resistance band lateral walks
Core stability training

4. Running Technique & Load Management

Gradual reintroduction of running — starting shorter, flatter runs
Correcting stride length, cadence, and posture
Advising on footwear and surfaces
Avoiding sudden jumps in training load

5. Manual Therapy & Adjuncts

Deep tissue massage for tight glutes/hips
Joint mobilisation if stiffness present
Dry needling for trigger points
Education on foam rolling and recovery routines

6. Long-Term Prevention

Structured warm-ups and cool-downs
Regular hip/glute strengthening
Careful progression of training
Monitoring running form regularly
Cross-training to balance loading

Patient Story: “James from Belrose”

James, a 34-year-old recreational runner from Belrose, came to our Frenchs Forest clinic with stabbing knee pain every time he ran beyond 5 km. He was frustrated after resting for weeks, only to flare up as soon as he tried again.

On assessment, we found weak glutes and hip stabilisers, plus a running stride that caused his knees to collapse inward. His ITB was overloaded every time he ran longer distances.

We began with pain relief strategies, soft tissue release, and activity modification. Then, we introduced a progressive strengthening program targeting his glutes and hip control, combined with running technique retraining. Within 8 weeks, James went from struggling with 5 km to comfortably running 15 km, pain-free.

Six months later, he’s still running regularly — and he even completed the Sydney Half Marathon without any flare-ups.

Common Mistakes in ITB Rehab

Relying only on foam rolling without strengthening
Jumping back into long runs too soon
Ignoring footwear or running surface
Skipping hip and glute strengthening once pain improves
Hoping rest alone will “cure” it

Sample Exercises

Exercise	Instructions	Benefit
Clamshells	Lie on side, knees bent, lift top knee up while feet stay together	Strengthens glute medius
Hip thrusts	Back on bench, thrust hips upward with weight	Improves glute power
Single-leg squats	Slow controlled squats on one leg	Builds knee control
Side band walks	Step sideways against band resistance	Improves hip stability
Foam rolling	Roll outer thigh/hip area gently	Relieves tension in ITB and surrounding muscles

Recovery Timeline

2–4 weeks: Pain relief and early strength work
4–8 weeks: Progressive strengthening, short runs reintroduced
8–12 weeks: Full return to regular running and sport
3–6 months: Building resilience, maintaining strength, preventing relapse

Key Takeaways

ITB friction syndrome is common in runners and athletes — but highly treatable with physiotherapy.
The key is strengthening hips and glutes, correcting running form, and progressing training smartly.
Don’t just rest and hope — active rehab prevents recurrence.
With the right plan, you can return to full training pain-free.

👉 Ready to take control of your ITB pain? Give us a call today on 9806 3077, or book online — just CLICK HERE.

References & Further Reading

Physiopedia: Iliotibial Band Friction Syndrome physio-pedia.com
Healthline: IT Band Syndrome Overview healthline.com
Runner’s World: How to Treat IT Band Syndrome runnersworld.com
PhysioWorks: ITB Syndrome Management physioworks.com.au
Cleveland Clinic: IT Band Syndrome Guide my.clevelandclinic.org
Sport Medicine Australia: Overuse Injuries sma.org.au

That’s your complete guide to ITB friction syndrome and recovery. Don’t let knee pain hold you back — give us a call today on 9806 3077, or book online, just CLICK HERE.