15/06/2026
Manual therapy v Strength training for ITBS in runners🏃🏽♀️ We have a winner!…
A new study from Khizar et al. (2026) compared an extensive manual therapy intervention with progressive strengthening exercises in 34 runners with ITBS. Pain and function were assessed at baseline and after the 6 week intervention period.
Strength training achieved superior results for both pain and function. The manual therapy group saw an average pain reduction of less than 1 point on the NPRS. When you consider that this involved deep friction massage, stretching, soft tissue mobilisation and foam rolling done 5 times per week it’s a less than impressive result!
These findings concur with previous research that found foam rolling and stretching was ineffective to change ITB stiffness (Pepper et al. 2021). Despite this we need to be cautious interpreting these results due to several limitations.
This is a small pilot study which doesn’t appear to have a power calculation or blinding of assessors. The study concluded that manual therapy improved pain and function despite not reaching the MCID in either outcome measure.
In fact, the mean change in both measures was less than the standard deviation they reported in the manual therapy intervention. With no control group it’s also impossible to know if these minor differences may have simply occurred with time.
Reference:
Khizar, H.F., Siva, S., Ramaswami, S., Hareeshankar, D., Fayaz, A. and Suganthirababu, P. (2026) ‘Effectiveness of Manual Therapy Versus Strength Training for Iliotibial Band Syndrome on Pain and Functional Recovery in Runners: A Pilot Study’, International Journal of Therapeutic Massage & Bodywork, 19(2), pp. 53–63. doi:10.3822/ijtmb.v19i2.1279.
