Iliotibial band (ITB) syndrome is an overuse problem that is often seen in bicyclists, runners, and long-distance walkers. Personally, it has been noted while Backcountry Skiing and Stand-Up Paddling (SUP). Many people ask me what causes pain on the outside of the knee just above the knee joint. It is ITB syndrome and it can be problematic. The discomfort may be so intense as to discourage you from participating in the often long and rewarding sessions of SUP and other endeavors. So what can be done about it?