Which of the following is a risk factor for ITB syndrome?

• A. Upper body training alone.
• B. Sedentary lifestyle with no running.
• C. Overuse, poor biomechanics, downhill running, leg length discrepancy, and weak hip stabilisers.
• D. Balanced training program.

Answer: (C)

Iliotibial band syndrome tends to arise from factors that increase repetitive stress on the IT band during running. The best answer highlights several key contributors. Overuse means increasing training volume or intensity too quickly, leading to repetitive knee flexion and friction where the IT band moves across the outer knee. Poor biomechanics—such as weak hip stabilisers and poor pelvis control—allow the knee to move abnormally (often toward valgus), which stacks more strain on the IT band. Downhill running places extra demands on the knee and hip as the leg repeatedly bends and extends, increasing IT band tension and friction. Leg length discrepancy creates uneven loading between legs, causing compensatory mechanics that irritate the IT band. Weak hip stabilisers undermine control of the thigh and pelvis during stance and movement, again increasing IT band strain.

In contrast, upper body training alone doesn’t load the IT band in a way that predisposes it to irritation, and a balanced training program with gradual progression and proper mechanics helps reduce these risks. A sedentary lifestyle with no running also wouldn’t be a risk factor, since ITB syndrome is tied to running-related loading.