IT Band Syndrome – Your Guide to Relief

Runners and Cyclists Listen Up!

IT Band syndrome

Mile after mile…all the miles…and then a few more miles– exercising, training, racing, you’ve put in the work and now your knee is paying for it. Whether it’s running, cycling, or a similar activity, pain on the outside of your knee is often from friction of the IT band. What causes this? Why do some athletes get this and others don’t? How can you find relief?

Here we’ll offer some answers to these questions and give you some exercises you can get started on today…

What Is The IT Band and Why Does It Hurt?

Your IT band (Iliotibial Band) is a thick sheet of connective tissue which attaches from muscles in your hip to the side of your knee.

Despite popular belief, IT band syndrome isn’t pain running up and down the side of your leg. Yes, this is where the IT band is located – but IT band pain is felt on the outside of your knee.

Friction between your IT band and your knee is what leads to pain 1. This friction is greatest when there’s tension on your IT band. When is there the most tension? When your knee is bent about 20–30 degrees – just after your heel hits the ground while running,2.

The repetition of bending and straightening your knee over and over while IT band tension is high – especially with increases in mileage and/or pace and while running downhill – can lead to pain3.

But it’s not the bending and straightening by itself that leads to pain. Plenty of athletes bend and straighten their knees repeatedly and don’t get any pain. The difference is in the tension of the IT band while the knee bends…

What Causes This Increase In IT Band Tension?

When we compare runners with IT band syndrome to those without, we find that the hip angles inward (adducts) more in the runners with IT band pain 4,5. With this increased angle of the hip, the knee caves inward and puts more tension on the IT band 6,7,8.

Why do some athlete’s hips angle inward? Weakness in the hip abductor muscles 9– the muscles that control the hip pushing outward10. If these muscles are stronger, they can resist the hip and knee from caving in.

In fact, studies show that runners with IT band syndrome have weaker hip abductor muscles than non-injured runners11,12. Thankfully, these same studies also show that strengthening the hip abductor muscles resolves IT band pain in 90% of runners in just 6 weeks 13.

The same can be true for you: if you strengthen your hip abductors, you will have more control of your hip and knee as you walk, run, and bike, putting less tension on your IT band.

Here’s how to do it…

Exercises For IT Band Syndrome

In addition to the following exercises, remember to gradually increase your pace, mileage, and hills as you train. Sudden increases in any of these can lead to injury.

In the meantime, try these exercises:

1. Resisted Side Steps

 

2. Hydrants

 

3. IT Band Stretch

 

Are we actually stretching the IT band here? Maybe…but remember, your IT band also attaches to the muscles at the hip14 – stretching these muscles will relieve some tension, too.

Question: What other exercises have you found to strengthen the hips? You can leave a comment by clicking here.


  1. Orchard et al. Biomechanics of iliotibial band friction syndrome in runners. Am. J. Sports Med., 24 (1996), pp. 375–379  ↩
  2. Orchard et al. Biomechanics of iliotibial band friction syndrome in runners. Am. J. Sports Med., 24 (1996), pp. 375–379  ↩
  3. C.A. Noble. Iliotibial band friction syndrome in runners. Am J Sports Med, 8 (1980), pp. 232–234  ↩
  4. Noehren B, et al. ASB clinical biomechanics award winner 2006: prospective study of the biomechanical factors associated with iliotibial band syndrome. Clinical Biomechanics. 2007;22(9):951–956.  ↩
  5. Fredickson et al., 2000. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin. J. Sport Med., 10 (2000), pp. 169–175  ↩
  6. Inman VT. The Joints of the Ankle. Baltimore, MD: Williams & Wilkins; 1976.  ↩
  7. Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther. 2003;33:671–676.  ↩
  8. Souza RB, Powers CM. Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. J Orthop Sports Phys Ther. 2009;39:12–19. http://dx.doi.org/10.2519/ jospt.2009.2885  ↩
  9. Fredickson et al., 2000. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin. J. Sport Med., 10 (2000), pp. 169–175  ↩
  10. Moore KL, Dalley AF. Clinically Oriented Anatomy. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005.  ↩
  11. Niemuth PE, Johnson RJ, Myers MJ, Thieman TJ. Hip muscle weakness and overuse injuries in recreational runners. Clin J Sport Med. 2005;15:14–21.  ↩
  12. Fredickson et al., 2000. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin. J. Sport Med., 10 (2000), pp. 169–175  ↩
  13. Fredickson et al., 2000. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin. J. Sport Med., 10 (2000), pp. 169–175  ↩
  14. Fredickson et al., 2000. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin. J. Sport Med., 10 (2000), pp. 169–175  ↩
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  • justabil

    A pt showed me an exercise of lifting one foot with the other with ankles crossed. Immediate relief. Long term prevention too when repeated. It was a kneecap being pulled by the tight it band.

    • Michael Curtis

      Interesting…is that in side lying?

      • justabil

        Seated facing forward.