Physiotherapy articles

Why does the external part of the knee hurt? Iliotibial band syndrome

This syndrome is related to sports overload, in endurance athletes and is known as the runner's knee or runner's knee

Our collaborator Healthing tells us in this article, the causes, prevention and treatment of Iliotibial band syndrome.

Lately, many triathletes come to the consultation saying they feel pain on the outside of the knee during exercise and that is usually aggravated in races involving downhill or even in everyday activities such as climbing stairs. This article aims to publicize the keys of this pathology and how it can be prevented and treated.

What is its possible origin?

This injury is caused by excessive rubbing between the iliotibial band and the femoral epicondyle. With the knee in extension, the iliotibial band remains anterior to the external femoral condyle, when the knee flexes, the band passes over the condyle and lies behind it. This repeated event, as if it were a windshield wiper, could cause irritation and inflammation of the existing bursa between the iliotibial band and the femoral epicondyle causing pain.

With this injury mechanism, it is easy to understand that this syndrome is related to sports overload, in long-distance runners (hence known as knee runner's knee), or in sports that require repeated push-ups of the knee as for example cycling, although it can also develop after a direct contusion on the area.

However, if it were only for this, the incidence would be much higher, therefore, there are many factors that contribute to suffer it as for example alterations in the biomechanics of the subject, anatomical morphology of the hips (especially if they have a wide pelvis), alterations in the tread, shortening and weakness of certain muscles, bad technique during sports practice such as pedaling with the toes pointed inwards, bad position of the saddle, etc.

How do we treat it?

Undoubtedly, the first thing that must be done is a good physiotherapeutic diagnosis, help us clarify the causes of the injury and if it is really that structure that is causing the condition, since the pain on the external face of the kneea may be the result of other injuries such as popliteus tendon tenosynovitis, damage in the external meniscus or simply a muscle contracture that is causing a pain referred to that area, among others.

Subsequently, the possible triggers of the injury to focus the treatment in an optimal way and not just eliminate the symptoms but root solve the cause of the pathology.

The most immediate objective is to eliminate pain and improve the neuromotor and biomechanical capacity of the patient, for this we rely on manual therapy, osteopathy and advanced physiotherapy techniques such as neuromodulation and percutaneous intratissular electrolysis if indicated. In addition, to accelerate the process of recovery of the athlete are indicated technologies such as high power laser, Game ReadyⓇ y VacusportⓇ (

Once the symptomatology has improved, we will focus on Do an active job to avoid relapses, based on the Redcord NeuracⓇ therapy ( and in ImooveⓇ, improving joint biomechanics in a more global and harmonic way, stimulating neurofunctional coordination.

Ilitibial Belt Treatment

1 image: Rehabilitation exercises for the treatment of the iliotibial band using the ImooveⓇ platform.

Having said that, the most effective treatment is prevention, therefore all triathletes should pay close attention to make a good sporting gesture, maintain a good postural ergonomics, use proper footwear etc. and of course, go to the physiotherapist usually, we are waiting for you in Healthing!


More info


Healthing, Calle Serrano, 61. 4th floor - 28006 (Madrid)

Telephone: + 34 91 426 29 24

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