Iliotibial Band Syndrome (ITBS)

Acronyms Medical

Runner ‘s knee is also known by the terms iliotibial band chafing syndrome, tractus syndrome or iliotibial band syndrome and by the abbreviation ITBS. Runner’s knee is a painful condition on the outside of the knee that can affect both athletes and non-athletes.

What is runner’s knee?

Runner ‘s knee is caused by improper loading of the knees while running. Overexertion can also be the cause of runner’s knee. In runner’s knee, the pain occurs in the iliotibial band, a tendon plate that extends from the thigh to the shinbone on the outside of the body.┬áSee AbbreviationFinder for abbreviations related to ITBS.

This tendon plate rubs against the knee joint bones and causes the pain. This chafing process inflames tissue and can cause sharp pain. This pain on the outside of the knee joint first occurs when walking downhill or when jogging and can also be noticed during normal walking.

Marathon and long-distance runners are most affected by runner’s knee, although incorrect loading can also be caused by other causes in non-athletes and can result in runner’s knee.


The causes of pain in the runner’s knee include the well-known mistakes made in running. Skipping a warm-up or not stretching enough is the first cause of runner’s knee. The causes of runner’s knee often lie in an increase in running training that is too rapid.

The wrong footwear is particularly often the cause of runner’s knee and running on too hard a surface also contributes to runner’s knee. Another cause of runner’s knee is bowlegs and other leg deformities. Congenital malpositions can also be a cause of a runner’s knee.

Since the tractus iliotibialis runs from the pelvis over the outside of the thigh to the tibia head, any incorrect posture when running or walking has a permanent effect on the knee joint and can cause a runner’s knee if the load is too heavy and persistent. Runner’s knee occurs when the iliotibial band is too short and rubs against the bones of the knee. The cause of runner’s knee can therefore also be a tendon injury.

Symptoms, Ailments & Signs

Runner’s knee, also known as iliotibial band syndrome, is characterized by severe knee pain that occurs especially when the knees are put under strain. It is a stabbing pain located below the kneecap. Local inflammation of the tissue occurs there when the tendon plate on the outside of the thigh towards the tibia rubs against the bones of the knee joint.

The symptoms initially only occur when descending mountains. After a certain amount of time, even minor exertion is enough to cause the stabbing pain. These become noticeable even with normal running or walking. In later phases of the iliotibial band syndrome, even climbing stairs or bent legs when sitting cause discomfort.

Touching the kneecaps can also cause severe pain. Sometimes bursitis also develops, which is also characterized by persistent severe pain, significant swelling in the knee joint, heat build-up, and restricted movement. Furthermore, with iliotibial band syndrome, joint effusion sometimes also forms in the knee joint.

Another typical symptom is an audible crunching in the knee when moving. In principle, there are good chances of recovery if the affected knee joints are spared. The symptoms then subside within one to two weeks. However, if the knee joint is subjected to further strain, the cartilage can also be irreparably damaged and lead to chronic symptoms.

course of the disease

The course of the disease in runner’s knee begins with any discomfort associated with running, jogging or walking. If pain occurs in the knee, it should always be handled very carefully. Since training mistakes are often the cause, if you pay attention to yourself, a lot can be done to prevent a runner’s knee in its infancy.

Taking cues about training speed seriously and using a soft running surface, appropriate footwear, and proper warm-up training are the best tools to counteract the progression of runner’s knee disease. If the course of the disease is advanced, bandages must be applied and training may temporarily no longer take place.

The frequency with which a runner’s knee occurs is 28 percent for female runners and 24 percent for male runners. If the runner’s knee continues to be subjected to excessive or incorrect strain despite initial problems and pain, this can lead to a chronically diseased runner’s knee.


As a rule, a runner’s knee primarily leads to very severe and uncomfortable pain. The pain is stabbing and has a very negative effect on the patient’s quality of life. Furthermore, the pain can also spread to other regions of the body, so that it is not uncommon for knee pain to occur. Especially at night, runner’s knee can lead to sleep disorders and depression.

It is not uncommon for those affected to be irritable due to the constant pain and suffer from mental disorders. The patient’s extremities are warm from the runner’s knee and are often also swollen. Bruising of the affected joints is not uncommon. In general, the patient also has restricted mobility, which can make everyday life significantly more difficult for the person concerned. Severe symptoms occur, especially under stress.

As a rule, treatment can be carried out with the help of medication and does not lead to any further complications. In this way, inflammation can be avoided. Furthermore, the person affected by the runner’s knee is also dependent on therapy or massages to reduce the symptoms. The patient’s life expectancy is usually not reduced by runner’s knee. Overweight people must also reduce their body weight.

When should you go to the doctor?

Runner’s knee is swelling and inflammation in the knee that most commonly affects joggers and athletes. Normal movement is very difficult to achieve with a runner’s knee. Even the slightest stress triggers pain, so that a visit to the doctor should not be delayed. In this context, inflammation of the joints often occurs, which is easily visible to the human eye. At the first signs of such an inflammation, a doctor should be consulted immediately. Otherwise there is a risk of an abscess.

An abscess is a cavity filled with pus. If this clinical picture remains without medical and drug treatment, there is even a risk of blood poisoning. If you have symptoms of runner’s knee, you should definitely see a doctor. A speedy recovery can only take place with appropriate treatment. Anyone who completely forgoes such treatment exposes themselves to a great risk. In the worst case, permanent consequential damage can occur. The knee should be relieved so that joints, tendons and muscles are not further damaged.

Treatment & Therapy

A runner’s knee can be recognized in its early stages by the pain. Therefore, this pain also determines the therapy from the beginning. Cooling the knee and taking anti-inflammatory medication as well as a stabilizing bandage are the first steps in therapy for runner’s knee.

This includes an unconditional protection of the knee. If the problems with the runner’s knee are particularly severe, the doctor treating you can also inject anesthetics. A break from running for up to three months may then be necessary. The next steps are physiotherapy and a light build-up training and professional supervision.

If you have too much body weight, you can reduce it. Because a runner’s knee is put under even more strain by too much weight. Therapeutic means for runner’s knee also include massage and heat applications.

Outlook & Forecast

The prognosis of runner’s knee depends on the extent of the existing disorders and the cooperation of the person concerned. If the patient is not willing to do something to keep himself healthy, there is no good chance of healing. If you are overweight, weight loss is essential to permanently relieve your symptoms. This can be achieved independently by the person concerned with or without further medical treatment. In cooperation with a doctor, however, the long-term and lasting successes improve. In addition, possible complications are avoided.

If the runner’s knee was caused by incorrect loading, a freedom from symptoms can be achieved with physiotherapeutic treatment and the willingness of the person concerned to change. Motion sequences are optimized in targeted training and must also be implemented stably outside of therapy.

If the cause of the condition is overuse of the knee, recovery can also be achieved if the patient initiates long-term changes in exercise tolerance. Physiotherapy exercises and the implementation of medical information about the functioning of the human organism and the joints must be carried out independently by the patient. If this is the case, a good prognosis can often be made. If there are no other injuries or damage to the joint, healing is often achieved within a few weeks or months.


The preventive measures for runner’s knee are the right warm-up and stretching, suitable shoes and a soft running surface as well as the ideal weight. In addition, you have to pay attention to yourself during training.


Runner’s knee usually leads to unpleasant and severe pain in those affected, which can sometimes last for a long time. That is why it is important for those affected to rest extensively and to reduce sporting activities to a minimum. The training should only be taken up cautiously in order to avoid a relapse.

If the pain has spread to surrounding regions of the body and causes additional disorders, this can have an enormous impact on the psyche. Accompanying insomnia can lead to those affected being permanently irritable and suffering from fatigue. This can lead to depression and other mental illnesses. However, constructive discussions with friends and family can ensure that those affected deal with their suffering more confidently.

In addition to possible follow-up checks by the treating doctor, it is important that those affected find distraction in their social environment and find joy in it. This may help them get through the periods of inactivity during the recovery process better.

You can do that yourself

In the acute phase of the disease, cooling compresses have a pain-relieving effect; alternatively, pain-relieving ointments from the pharmacy can also be applied. Resting the runner’s knee is necessary for at least two to six weeks, otherwise chronic symptoms can develop. Light running training should only be resumed when the symptoms have completely subsided. A bandage stabilizes the knee joint during this time and supports healing.

When you resume training, make sure you warm up properly, paying particular attention to the outside of the leg. Good shoes provide the necessary cushioning, and foot deformities can be compensated for with individually fitted insoles. Increasing the amount of exercise too quickly and running on consistently hard ground often result in recurrence of the iliotibial band syndrome. Shorter units on forest trails are far easier on the knees than long road runs.

If the runner’s knee is due to excessive strain caused by an incorrect running style, expert advice and correction from an experienced running coach is advisable. In some cases it can make sense to replace part of the running training with other endurance sports such as cycling or swimming. In addition, the torso and hip muscles should be strengthened and stabilized through targeted exercises in order to achieve optimal movement when running.