Pain on the side of the knee
- Pain Relief Therapy
- Feb 13
- 2 min read
Iliotibial Band Syndrome: A Therapist’s Perspective
In my office, I frequently see runners, cyclists, and athletes walk into my clinic with lateral knee pain. One of the examples of the case that is typical a patient named Jake, a 32-year-old avid marathon runner who had been struggling with knee pain for several months. His symptoms and story were classic for Iliotibial Band Syndrome (ITBS)—a common overuse injury that I’ve treated countless times.
Jake’s Symptoms: A Classic ITBS Case
When Jake first came in, he described a sharp, burning pain on the outer side of his knee, which worsened during his long runs and even while descending stairs. He told me that the discomfort usually started a few kilometers into his run and gradually intensified, sometimes forcing him to stop altogether.
Unlike ligament injuries or meniscus tears, ITBS doesn’t cause swelling inside the knee joint. Instead, patients often feel tenderness when pressing on the lateral femoral epicondyle (the bony prominence on the outer side of the knee). Jake had this exact symptom, and his pain worsened when performing a single-leg squat—a key indicator that his iliotibial band was irritated.
Diagnosing ITBS: Clinical Examination and Movement Assessment
Diagnosing ITBS is primarily clinical, meaning I rely on a combination of patient history, movement tests, and palpation rather than imaging like MRIs or X-rays (unless another condition is suspected).
For Jake, I conducted a Noble’s Compression Test, where I applied pressure to his iliotibial band near the knee while he bent and straightened his leg. As expected, this replicated his pain, confirming my suspicion of ITBS.
Treatment
The first step in Jake’s rehab was reducing pain and inflammation. I advised him to modify his training, avoiding long-distance runs and downhill running, which aggravate ITBS. He also began a regimen of ice therapy, self-massage with a foam roller, and gentle stretching of the iliotibial band, glutes, and hip flexors.
I was also performing a combination of manual techniques like myofascial release, trigger point therapy and deep tissue massage around gluteal muscles and quadriceps.
Once the pain was manageable, we focused on strengthening and correcting movement patterns. Jake’s weak gluteus medius and core muscles were a major issue, so I introduced exercises like:
Clamshells and side-lying leg raises to strengthen the gluteus medius
Single-leg bridges to improve hip control
Lateral band walks to build hip and knee stability
Eccentric squats and step-downs to enhance knee control
Recovery and Return to Running
After six weeks of rehab, Jake was able to return to running without pain. He continued his strength training and mobility work, which helped prevent recurrence. Today, he’s back to marathon training, wiser about injury prevention.
ITBS is frustrating but completely treatable with the right approach. If you’re struggling with lateral knee pain, don’t ignore it—early intervention makes all the difference!
Mateusz "Matt" Ciesielski
Pain Relief Therapy
07784751656
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