How to Help Heal IT Band Syndrome

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In lay terms, the IT (illiotibial) Band runs from the lateral hip and attaches down below the outside of the knee. The iliotibial band is a strong, thick band of fibrous tissue that runs along the outside of the leg. The IT band starts at the hip and runs along the outer thigh and attaches on the outside edge of the shin bone (tibia) just below the knee joint. The band works with the quadriceps (thigh muscles) to provide stability to the outside of the knee joint during movement.


IT Band pain is one of the most common of running injuries, usually manifested in the form of pain on the side of the knee although it is sometimes felt up in to the hip area as well.

In many cases, it is thought that IT Band pain is caused by a muscle imbalance caused from running downhill fast or from running on flat, even, man made surfaces in combination with over-striding/heel striking.   IT Band Typically, the runner with IT Band pain has central Quadricep muscles that are too strong in relation to the Gluteus Medius and Minimus (stabilizing muscles of the butt). Since the Glutes are unable to hold tension, the IT Band is pulled tighter across the side of the knee, causing the commonly felt outside of knee pain.

IT band syndrome is common in runners who perform unbalanced, repetitive exercise such as running only on one side of a crowned road, or only running one way around a track. Most roads slope off to the sides and running along the edge causes to the outside foot to be lower than the inside foot. This in turn causes the pelvis to tilt to one side and stresses the IT band.

The biomechanical abnormalities that may lead to IT band problems include: excessive pronation of the foot, leg length discrepancy, lateral pelvic tilt, and "bowed" legs. Muscle tightness or lack of flexibility in the gluteal (buttock) or quadriceps (thigh) muscles may increase the risk of IT band injuries. Sports physical therapists often use video tape analysis to uncover any biomechanical problems and make corrections in technique or muscle weakness or tightness.



Like with many injuries of this nature, the key to success is getting to the root of the problem by:


1) Letting the affected area relax & calm down

2) Stretching to loosen up the tension

3) Strengthening to correct the imbalances


Below are some specific ways to heal the IT Band Syndrome.


  • Reduced Activity – Just enough for the area to calm down—a few days to just beyond a week is usually enough. IT Band problems don’t necessarily get better with rest beyond a couple of weeks. Many runners report taking six months or even a year off and coming back to the same problem as soon as they start back in to a training program. This is likely due to the fact that in most cases, a muscle imbalance stays a muscle imbalance. The other piece of this is that a runner doesn’t usually change their running technique drastically after a break either.
  • Foam Roller Myofacial Release -  While the pain is felt down by the knee, the root of the problem is up in the hip area. The use of Massage, a foam roller or other similar treatments will help to reduce the scar tissue that can keep injury recurring.
  • Stretching & Strengthening -  There has been great success with those who do ‘Side-leg lifts’, ‘Standing side leg lifts', and one legged squats in order to combat the muscle imbalance.  Pair the strengthening with IT Band stretching exercises and using a foam roller.
  • Run on Even Surfaces - Get off the uneven: road, treadmill, and/or trail. You might need to walk the downhill. In addition, walking any relatively steep uphill portions of the run will keep the quadricep muscles from being worked as hard and allow the runner to go longer without pain.
  • The use of an IT Band Strap - These straps are placed above the knee and change the point of tension on the IT Band.   In many runners they are effective at reducing the pain. In most situations, an IT Band strap reduces discomfort but doesn’t necessarily help the injury to get better.

Once you notice ITB pain, the best way to get rid of it for good is to rest immediately.

That means fewer miles, or no running at all. In the majority of runners, resting immediately will prevent pain from returning. If you don't give yourself a break from running, ITBS can become chronic.

While you're backing off on your mileage, you can cross-train.   Swimming, pool running, cycling, and rowing are all fine. Stair-climbing is not, because it is too much like running.

If your ITB problem doesn't get better after several weeks, seek help from a sports-medicine professional.  You may need a cortisone injection to break up scar tissue and help speed healing.  But cortisone presents its own risks, as it can weaken ligaments and tendons.  Consider cortisone injections as a "second-to-last resort."
Your last resort is surgery to release and mobilize the IT band.


 Prevention of IT Band Syndrome: 

Here are some steps you can take to prevent iliotibial band syndrome:

  • Most importantly, always decrease your mileage or take a few days off if you feel pain on the outside of your knee.
  • Walk a quarter- to half-mile before you start your runs.
  • Make sure your shoes aren't worn along the outside of the sole. If they are, replace them.
  • Run in the middle of the road where it's flat. (To do this safely, you'll need to find roads with little or no traffic and excellent visibility.)
  • Don't run on concrete surfaces.
  • When running on a track, change directions repeatedly.
  • Schedule an evaluation by a podiatrist to see if you need orthotics.
  • Avoid doing any type of squats.


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