28 November 2021

How to prevent common running injuries: ITB

December 30, 2015

Even if you’re a seasoned marathoner going for a PB, or this is your first foray into long distance running – the one thing that both seasoned and novice runners need to be aware of is avoiding chronic, overuse injuries.

In a series of articles we highlight some of the most common running injuries – ITB, runner’s Knee, shin splints – how to treat them and the best practices to prevent them – as they keep telling us, prevention is better than cure!


ITB or ilio-tibial band friction syndrome is a repetitive-use condition which is very common in runners. The ITB runs along the outside of your thigh, and joins the pelvis to your knee, over the lateral femoral epicondyle (your hip bone is connected to your thigh bone…). Thus when the ITB is tight and irritated it often manifests as lateral knee pain (pain on the outside of your knee), and swelling or thickening of the ITB.

Possible causes

This syndrome often occurs in runners (and sometimes cyclists) who have malalignment and structural asymmetries of the foot and lower leg, such as genu varum (bow-leggedness for those of us not schooled in Latin), pronation of the feet and a leg-length discrepancy (i.e.: one leg is shorter than the other, which is actually quite common!). It is also caused by weak hip abductor muscles and multifidis muscles.

How to treat it

Follow the RICE procedure for any overuse injuries. That is: Rest – if you have a lot of pain, rest your injury, take time off from your training schedule. Rather miss a few days training than cause serious damage and miss the marathon completely! Ice – apply ice to the injured area to reduce inflammation. Compression – use a support or bandage to help reduce swelling. Elevation – raise the injured area above heart-level to reduce blood flow to the area, which will decrease the swelling.

Biokineticist and sports massage therapist, Christine Van Niekerk (www.physiosw19.co.uk), who is a 3 x Ironman athlete and seasoned marathon runner herself, recommends using a foam roller for ITB syndrome (these are cylindrically shaped, and cost around £10-15), and deep tissue massage to release the tightness. Both are proven to be effective for releasing the ilio-tibial band.

How to prevent it

If you have a foot and leg alignment discrepancy, seek professional advice to correct these, for example with orthotic shoe devices which you can place in your running trainers.

Always stretch after your run, taking time to stretch all the major muscle groups, holding each stretch for around 30 seconds for maximum benefit, and use a foam roller on your ITB after runs. Lay on your side and place the foam roller under your hip, moving your body so that the roller moves downwards towards your knee – repeat. A necessary evil I’m afraid!

Foam roller

It is also worth investing in regular massages if you are training for the marathon – it can keep your muscles agile and you are less likely to get an injury, whilst reducing muscular pain too!

Happy running!

Bianca Fermi, Sportsister

The Women’s Sports Magazine


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