There are many reasons as to why ITB Syndrome may have been triggered. Some of the most common causes of ITBS are listed below:

Abnormalities in the individuals leg/feet anatomy:

  • Supination of the athletes foot
  • Excessive lower leg rotation due to over-pronation, which will cause friction and inflammation of the ITB
  • High or low arches
  • The force at the knee when the foot strikes (especially during endurance training)
  • Uneven leg length causing strain
  • Bowlegs or tightness about the iliotibial band
  • Excessive wear on the outside heel edge of a running shoe (compared to the inside) is one common indicator of bowleggedness and poor form for runners


Common muscle imbalance causes are:

  • Weak hip abductor muscles
  • Weak/non-firing multifidus muscle

An individuals training habits:

  • Always Running on banked or cambered surfaces (such as the shoulder of a road or an indoor track). This bends the downhill leg slightly inward and causes extreme stretching of the band against the femur
  • Insufficient warm-up or cool-down period
  • Excessive up-hill and down-hill running can cause additional strain and exaggerate the problem
  • In cycling, having the feet “toed-in” to an excessive angle can cause friction of the IT band over the femur
  • Excessive running up and down stairs
  • Hiking long distances
  • Longer distance Rowing