ITB Syndrome and Pilates: Solving the Real Cause of Outer Knee Pain

Iliotibial Band Syndrome (ITBS) causes pain on the outside of the knee. It is common in runners and walkers, but it also appears in people who squat, lunge or climb stairs frequently without good hip control.

The IT band is a thick band of connective tissue running from the outside of the hip to the outer knee. It does not “tighten” in the way a muscle does. Most of the time, the real issue is poor hip stability.

ITBS is usually a load-management problem. Common contributors include:

• Weak glute medius

• Poor pelvic control

• Repetitive knee bending under load

• Sudden increases in activity

• Imbalance between left and right sides

• 
  

If your hip is not stable, your knee absorbs more strain. Pilates addresses the source, not just the symptom.

We prioritise:

• Side-lying leg work in small, controlled ranges

• Clams to activate lateral hip muscles

• Bridge work with alignment focus

• Single-leg balance

• Core stability without excessive tension

  
  

Slow tempo matters. Quality matters more than repetitions.

Mobility work for hips, calves and thoracic spine can reduce compensations further down the chain.

During a flare-up, we temporarily reduce:

• Deep lunges

• Repetitive step-ups

• High-rep squats

• Jumping

• Momentum-based side kicks

• 
  

Stretching the outside of the thigh aggressively rarely solves ITBS. Strong, well-coordinated hips do.

When your pelvis is stable and your glutes are doing their job, your knee becomes a hinge again instead of a shock absorber.

If lateral knee pain has been holding you back, structured Pilates can restore control and confidence.

Contact us for details of the Pilates and Gentle Pilates face-to-face classes in Oxfordshire around Didcot and Abingdon, or online classes to do live or on demand.