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Outer Knee Pain When Running? It Could Be ITB Syndrome

Published: 20 Apr 2026

Have you recently increased your running distance, time, or training frequency and started to notice pain on the outside of your knee?

Outer knee pain is a common issue for runners and active individuals. One of the most frequent causes is iliotibial band syndrome (ITB syndrome). You can read about other causes of knee pain in runners, here.

Not only running though, ITBFS has been associated with sports including cycling, swimming, hockey, soccer, basketball and tennis.

What is ITB Syndrome?

Iliotibial band syndrome (ITB syndrome) is one of the most common causes of pain on the outside of the knee, particularly in runners.

The iliotibial band (ITB) is a thick band of connective tissue that runs from your hip down to the outside of your knee. It plays an important role in stabilising both the hip and knee during movement.

Image credit: https://www.orthopaedicsurgeon.com.sg/patients-education/leg/iliotibial-band-friction-syndrome/

ITB syndrome occurs when the tissues on the outer side of the knee become irritated due to repetitive bending and loading of the knee, especially during activities like running or cycling.

What Causes ITB Pain?

ITB syndrome is typically an overuse injury, often linked to changes in training.

Common contributing factors include:

• A sudden increase in running distance, speed, or frequency
• Changes in training surface (e.g. road, trail, camber)
• Weakness in the hip muscles (particularly the glutes)
• Reduced strength or control around the knee
• Running technique or biomechanics
• Individual differences in anatomy and movement patterns

While ITB pain was historically described as a “friction” problem, current understanding suggests it is more related to compression of tissues at the outside of the knee during repeated movement.

Common Symptoms of ITB Syndrome

You may be experiencing ITB syndrome if you notice:

• Pain on the outside of the knee (sharp, burning, or aching)
• Pain during running, cycling, or repetitive knee movements
• Symptoms that ease with rest but return with activity
• Discomfort when going up or down stairs
• Pain with squatting or lunging
• Tenderness on the outside of the knee
• Occasionally, a snapping or tight sensation

How is ITB Syndrome Treated?

The good news is that most cases of ITB syndrome respond very well to physiotherapy.

Effective treatment focuses on addressing the underlying cause, not just the symptoms.

Your rehabilitation may include:

• Load management
  Adjusting your training volume and intensity to allow symptoms to settle
• Strength training
  Targeting the hip and glute muscles to improve control and reduce stress on the knee
• Movement and running technique assessment
  Identifying patterns that may be contributing to your symptoms
• Mobility and flexibility work
  Addressing stiffness in surrounding muscles
• Gradual return-to-running program
  Helping you safely build back to your desired level of activity

At The Healthy Body Company, we combine hands-on physiotherapy with gym-based rehabilitation to ensure you not only recover—but return stronger and more resilient.

When Should You See a Physiotherapist?

If your knee pain is:

• Persisting despite rest
• Limiting your ability to run or exercise
• Repeatedly returning when you increase training

it’s worth having it assessed by your trusted health professional.

Early management can prevent a short-term irritation from becoming a longer-term issue.

ITB Syndrome Treatment in Sydney

At The Healthy Body Company, we regularly help runners and active individuals manage outer knee pain across our clinics in Penrith, Jordan Springs, Mount Annan, and Caringbah.

Our physiotherapists provide tailored rehabilitation programs that combine hands-on treatment, strength training, and structured return-to-running plans, helping you get back to what you enjoy with confidence.

Frequently Asked Questions

What causes pain on the outside of the knee when running?

The most common cause is ITB syndrome, often linked to increased training load, muscle weakness, or changes in running habits.

Should I keep running with ITB pain?

Running through pain can worsen symptoms. Modifying your training and getting guidance from a physiotherapist is recommended.

How long does ITB syndrome take to recover?

Recovery varies, but many people improve within a few weeks with the right rehabilitation approach.

Struggling With Outer Knee Pain?

If you’re dealing with pain on the outside of your knee, you don’t have to manage it alone.

Our team can assess your movement, identify the cause of your symptoms, and guide you through a structured plan to get you back to running and activity.

Book an appointment with The Healthy Body Company today

References

1. Aderem, J., & Louw, Q. (2015). Biomechanical risk factors associated with iliotibial band syndrome in runners: a systematic review. BMC Musculoskeletal Disorders, 16(1). https://doi.org/10.1186/s12891-015-0808-7
2. Brukner, P., Clarsen Ben, Cook, J., Cools, A., Crossley, K., & Hutchinson, M. et al. (2017). Brukner & Khan’s clinical sports medicine: Volume 1 injuries (5th ed., p. Chapter: Knee pain). McGraw-Hill Education.
3. Fredericson, M., & Baker, R. (2016). Iliotibial Band Syndrome in Runners: Biomechanical Implications and Exercise Interventions. Physical Medicine And Rehabilitation Clinics Of North America, 27(1), 53-77.
4. Miccio, S., Berardi, A., Tofani, M., & Galeoto, G. (2021). Conservative Rehabilitation Treatments of Iliotibial Band Syndrome: A Systematic Review. Muscle Ligaments And Tendons Journal, 11(01), 29. https://doi.org/10.32098/mltj.01.2021.04