The iliotibial band, or IT band, is a powerful, ligament-like structure running from your pelvis, down the outside of your thigh, to your shinbone. Think of it as your body’s natural spring—storing and releasing energy with each step. As your leg swings back, the IT band tightens, and when your foot lifts off the ground, that stored energy propels you forward. It’s a key stabiliser for your hip and knee, playing a crucial role in keeping you moving efficiently.
Your glutes and tensor fascia latae (TFL) muscles anchor into the IT band, influencing its tension and stability. Weakness or lack of control in these muscles can lead to imbalances, like your knee drifting inward during movement—a common culprit in many injuries.
What is IT Band Syndrome?
IT band syndrome is a common issue among runners, with studies suggesting that 12% to 52% experience it at some point. While traditionally called “friction syndrome,” current research shows that pain isn’t caused by friction but rather by the compression of a sensitive fat pad near the outside of the knee.
The hallmark symptom? Pain on the outside of the knee, which can range from a sharp sting to a dull ache. It often flares up during activities like running, climbing stairs, or tackling hills—especially downhill. In severe cases, pain may radiate up the thigh toward the hip and cause tenderness along the knee.
What Causes IT Band Syndrome?
The primary driver of IT band syndrome is overuse. About 60% of cases stem from training errors, such as increasing running mileage or hill work too quickly. A weak hip and poor leg alignment—like a “crossover” running gait, where feet land too close together—can also overload the IT band.
Should You Stop Running?
Not necessarily. If reducing mileage or avoiding hills keeps pain at bay, you might be able to keep running. However, if even light running worsens the pain, it’s best to stop, let it settle, and gradually rebuild.
Be cautious with cross-training. For example, excessive cycling could exacerbate IT band issues due to repetitive stress on the same areas.
How to Address IT Band Syndrome
Healing requires addressing the root cause of the problem. The IT band itself isn’t the villain—it’s the supporting players like weak glutes, unstable hips, or overpronating feet that often need attention. Here’s how to tackle it:
- Manage Your Load: Cut back on high-impact activities to calm inflammation. Gradually reintroduce them as your body adapts.
- Strengthen Key Muscles: Focus on hip and glute strength with controlled exercises that progress over time.
- Gait Adjustments: Minor tweaks, like widening your stride or increasing cadence slightly, can redistribute the load more effectively.
Exercises to Strengthen and Stabilise
Strength training and movement control exercises are the foundation of recovery. Here are some of my go-to recommendations:
- Hip Thrusters: Build glute strength by lifting your hips while supported by a bench or stability ball. Start with bodyweight and add resistance over time.
- Hip Hikes: Improve lateral hip strength by lowering and raising your pelvis from a step. Add weights for progression.
- Banded Glute Pulley: Use resistance bands to activate your glutes by pulling one leg diagonally backward while balancing on the other.
For more dynamic challenges:
- Step-Ups: Step onto a box, driving your knee forward while maintaining hip stability.
- Walking Lunges: A running drill that builds control and improves foot placement.
Beyond Exercises: Comprehensive Care
Foot and ankle control also play a big role. Poor mechanics in these areas can increase stress on the knee and hip. Strengthening your feet and improving your running form can be game-changing.
Your Path to Recovery
IT band syndrome doesn’t have to side line you indefinitely. With a targeted plan focusing on strength, stability, and controlled progression, you can get back to running pain-free. The key is understanding your body’s mechanics, addressing weaknesses, and making gradual, thoughtful adjustments to your training. Let’s move forward—stronger and smarter.