Understanding Knee Pain

Is It ITBS or PFPS?

If you’re a casual runner and have started to feel a dull ache in your knee, you’re not alone. At SportsFit Gladesville, we regularly see runners with two common types of knee pain: Iliotibial Band Syndrome (ITBS) and Patellofemoral Pain Syndrome (PFPS).

They can feel similar, but they have different causes — and knowing which one you have helps guide the right treatment and prevents long-term injury.

Patellofemoral Pain Syndrome (PFPS)

What it feels like: Pain under or around the kneecap that’s worse when running uphill, climbing stairs, or sitting with your knees bent for too long (“moviegoer’s knee”). It usually builds up gradually over weeks or months, and can come and go.

What’s happening: PFPS (sometimes called runner’s knee) occurs when there is pain around, behind, or on either side of the kneecap during activities like running or squatting. This can be caused by multiple factors, some of which include: muscle imbalances, especially around the hips and thighs, or changes in running load.

What research shows:

• Runners with PFPS often show weakness or poor control around the hips, causing the knee to roll in slightly during running.(Barton et al., Br J Sports Med, 2016)

• Hip and core strengthening are more effective for recovery than just focusing on the thigh muscles.(Ferber et al., J Orthop Sports Phys Ther, 2015)

• Exercise-based physiotherapy can reduce pain and improve function, especially when combined with load management and education.(Brancaccio et al., BMC Sports Sci Med Rehabil, 2025)

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How we treat it at SportsFit Gladesville:

• Assess your unique running technique and alignment.

• Build strength in your hips, glutes, and quads.

• Check your footwear and running surfaces.

• Develop a running plan designed specifically for you to promote recovery as quickly as possible whilst minimising the amount of time you are taken away from training. 

Iliotibial Band Syndrome (ITBS)

What it feels like:Pain on the outside of the knee, often sharp or burning, that gets worse with downhill running or long runs. It may start suddenly after increasing mileage or running speed.

What’s happening:The iliotibial band (IT band) is a thick piece of double-layered fascia (connective tissue) running along the outer thigh. When it becomes irritated where it crosses the knee, it causes pain during repetitive bending — common in runners with tight hips, weak glutes, or increased training loads.

What research shows:

• Hip muscle weakness and poor running mechanics are common in runners with ITBS.(Miller et al., Sports Health, 2020)

• A strengthening program for the hip abductors and glutes can improve pain and function better than stretching alone.(Beers et al., Int J Sports Phys Ther, 2020)

• Foam rolling and manual therapy can help, but strength and load management are key for long-term recovery.(Lavine, Curr Rev Musculoskelet Med, 2022)

How we treat it at SportsFit Gladesville:

• Assess your unique running technique and alignment.

• Strengthen hip stabilisers and core muscles.

• Check your footwear and running surfaces.

• Develop a running plan designed specifically for you to promote recovery as quickly as possible whilst minimising the amount of time you are taken away from training. 

The SportsFit Gladesville Takeaway

• Whilst it is important to acknowledge what the evidence tells us about specific types of training factors causing knee pain in runners, here at SportsFit we understand that every person is unique. 

• As a result, we make sure we tailor our assessments to your individual anatomy, movement patterns, and most importantly your goals. 

Book an assessment today to get back on track — stronger, faster, and injury-free.

References (for those interested):

1. Barton CJ et al., Br J Sports Med, 2016 — “Biomechanical characteristics of runners with PFPS.”

2. Ferber R et al., J Orthop Sports Phys Ther, 2015 — “Effects of hip strengthening on PFPS.”

3. Brancaccio G et al., BMC Sports Sci Med Rehabil, 2025 — “Effectiveness of physiotherapy interventions for PFPS.”

4. Miller RH et al., Sports Health, 2020 — “Biomechanics and risk factors for ITBS.”

5. Beers A et al., Int J Sports Phys Ther, 2020 — “Hip strengthening vs stretching for ITBS in female runners.”

6. Lavine R, Curr Rev Musculoskelet Med, 2022 — “Review of IT band syndrome management.”