Iliotibial Band Syndrome: How To Prevent And Treat This Common Running Injury

7 Exercises to Treat and Prevent IT Band Syndrome

Iliotibial Band Syndrome: How To Prevent And Treat This Common Running Injury

As runners, we expect a little fatigue and soreness from time to time. But any sort of sharp pain is your body’s way of telling you that something is wrong.

One of the most common sources of pain that can stop runners in their tracks is iliotibial band syndrome. Frequently misunderstood, IT band syndrome is often treated incorrectly.

Common treatments include ice, rest and stretching, and, while all of these have their place in treating a running injury, ITBS is best approached proactively.


The IT band is a thick, fibrous band of connective tissue that runs down the outside of your thigh. It originates from your gluteal muscles and tensor fasciae latae and connects just below your knee. Un “runner’s knee,” where pain is commonly felt around or below the kneecap, ITBS usually presents as pain on the outside of your knee.

ITBS can become a chronic pest of an injury if not treated correctly, so it’s important to tackle it early on. While rest will help you initially, a specific set of strength exercises is your best long-term solution. If you have never been affected by ITBS, good news: Prevention is definitely the best medicine.

Because the IT band is so intricately connected to the gluteals, a weak butt can contribute to decreased stability in the knee. When you’re fatigued, your hips and glutes are less able to compensate, and the knee can rotate excessively inward or outward. A flare-up of ITBS can come on abruptly and may feel a stabbing sensation on the outside of your knee.

If you’re suffering from ITBS, the first thing you’ll need to do is stop running temporarily. But this doesn’t mean that you should be completely sedentary. ITBS is best treated with active recovery, so even if you’re not running, you should be doing specific exercises to strengthen your weak areas and get yourself back on track quickly.

Both prevention and treatment of ITBS come from strengthening the hip and gluteal muscles. Why is this so effective? Simply put, most of us have a weak butt. Sedentary jobs and lifestyles contribute to this weakness, but strength training is a simple way to overcome it.

The beauty of the routine described below is that it can be used for prevention and recovery. If your injury is recent and relatively minor, you should be well on the road to recovery in 1–2 weeks.

Chronic, more serious cases may take longer, but don’t despair.

Treating the source of the problem will get you back to running eventually, and you’ll be stronger and more resilient than you were before your injury.

Rest assured that this treatment approach has worked for me (after a 6-month layoff) as well as thousands of other runners you who are suffering from ITBS.


This routine takes about 15 minutes to complete once you are familiar with the exercises. The only piece of equipment you’ll need is a rubber exercise band to increase resistance in some of the exercises. There are a variety of strengths available that can provide increasing levels of resistance.


Lie on your right side with both legs straight. Slowly raise your left leg about 45 degrees, then lower. Repeat on both sides. To make this move more challenging, use an exercise band around your ankles to increase resistance. Reps: 20–30 on each side

Lie on your right side with your knees bent at a 90-degree angle to your torso. Keeping your feet together, use your glutes to slowly open and close your legs a clamshell. Keep the motion controlled, and don’t allow your pelvis to rock throughout the movement. Use an exercise band just above your knees to increase resistance. Reps: 20–30 on each side

Lie on your back with your arms at your sides, knees bent and your feet on the floor.

Pushing your heels into the ground, use your glutes to raise your pelvis up until your body forms a straight line from your knees to your shoulders. Lower slowly, then repeat.

For a more advanced version, raise one leg into the air and perform the same exercise with each leg individually. Reps: 20–30 on each side

Lie on your side with your feet elevated 1–2 feet off the ground on a stable surface. Lift your torso using your hip muscles while keeping your spine stable, then lower slowly. Reps: 10–30 on each side

Stand with your legs about hip-width apart with an exercise band around your ankles. Take 10 steps to the right, then 10 back to the left. This is one set. The exercise band should remain tight enough to provide resistance throughout the entire movement. Reps: 3–5 sets

Stand on your right leg with your left knee raised out in front of you. Slowly lower yourself, balancing on your right leg and allowing your left leg to straighten out in front of you. Try to lower yourself until your quad is just about parallel with the floor, then slowly come back up. Reps: 5–15 per leg

Stand on your right foot. Start with your pelvis in a neutral position, and then drop the left side so it is several inches below the right side of your pelvic bone. Use your right hip muscle to lift your left side back to its neutral position. Reps: 10–30 on each side

Here are several key points to remember when treating ITBS:

  • See a doctor if pain persists despite ongoing recovery efforts.
  • Reduce the number of repetitions if needed.
  • If you’re currently injured, perform this routine every other day.
  • Other runner-specific core and strength workouts should be completed on alternating days.
  • Download an illustrated guide of a similar routine.

With appropriate treatment, your ITBS should be short-lived, and you’ll be back to running and stronger than ever.


Tips for Trail Runners—How to Avoid (and Treat) IT Band Syndrome

Iliotibial Band Syndrome: How To Prevent And Treat This Common Running Injury

Trail running is steadily building in popularity. From a public health perspective, this is great news. After all, trail running offers countless benefits for cardiovascular health, orthopaedic health, weight management, mental and emotional wellbeing, and more.

But what about the risks?

As Sports Medicine specialists, the physicians at Rothman Orthopaedic Institute have extensive experience treating trail runners. One of the most common orthopaedic injuries these runners experience is iliotibial band, or IT, band syndrome.

What measures can trail runners take to effectively prevent IT band syndrome? What IT band syndrome treatment options are available to injured athletes? The orthopaedic experts at Rothman Orthopaedic Institute address these questions and more below.

What Is IT band syndrome?

Are you experiencing one or more of the following symptoms?

  • Pain along the outside of the knee during running activity
  • Knee pain following activity
  • Physical tenderness centered around the knee
  • Physical tenderness in the buttocks
  • Inflammation centered around the outside of the knee
  • Redness and warmth around the outside of the knee
  • Sensations of clicking in the outside of the knee

If you run on a regular basis or participate in other sports that involve regular running activity, these symptoms may be the consequence of a condition known as IT band syndrome.

The iliotibial band, or IT band, is a thick band of connective tissue that runs from the hip to the top of the shin.

The portion of this ligament that extends down the side of the knee can become tightened due to repetitive, high-impact activity.

As the band tightens, friction between the IT band and the outside of the knee can cause serious pain, inflammation, and damage to the affected tissue.

Tips for Trail Runners: Preventing IT Band Syndrome

What can trail runners to prevent IT band syndrome? The following tips will help you to avoid this common condition.

  • Moderate your trail terrain Steep, hilly terrain and the uneven surfaces of off-road trails can expose the IT band to exaggerated stress. Begin trail running activity gradually; increase the duration of your runs and the intensity of the terrain you run on over time to allow your muscles and connective tissues to adjust. Even after adjustment, it is important to perform the majority of your training on moderate terrain trails.
  • Balance trail running with flat surface training Always intersperse trail training with lower-impact training on flat surfaces. This allows your IT band to recover from high-stress trail running without compromising your training schedule.
  • Stretch and exercise proactively IT band exercises and IT band stretches, such as these three targeted exercises, can help to loosen and strengthen muscles and tissues surrounding the IT band. A physical therapist or personal trainer can also recommend routines your specific symptoms.
  • Cut back on activity if symptoms emerge The most effective preventative measure for IT band syndrome is rest. Incorporate adequate rest and cross-training into your training routine. If symptoms of IT band syndrome begin to emerge, immediately reduce the intensity and duration of your trail running activity. If symptoms do not improve, temporarily cease running activity altogether.

Incorporating these measures, alongside general running safety precautions, into your training can help you to effectively prevent IT band injuries.

Treating IT Band Syndrome

What should you do if you are already experiencing the symptoms of IT band syndrome? For most patients, rest and moderation of activity will be sufficient for reversing this condition. If rest alone does not provide relief, however, there are numerous effective treatment options.

For most patients, non-surgical treatments will be sufficient for treating IT band injuries. These include icing, anti-inflammatory medication, and physical therapy. In the most severe cases, arthroscopic surgery may be recommended; the need for surgery, however, is rare.

Whatever treatment option you require, the Sports Medicine experts at Rothman Orthopaedic Institute can provide you with the most advanced, effective care available. To learn more about IT band syndrome treatment at Rothman Orthopaedic Institute or to schedule an appointment, please visit us here or contact us at 1-800-321-9999.


Treating and Preventing Iliotibial Band Syndrome

Iliotibial Band Syndrome: How To Prevent And Treat This Common Running Injury

Laura Kennelly had been running for several years before the pain hit. Two days after finishing her first marathon, she went off with her regular running group for an easy 5-miler. But after 2 miles, the outside of her leg began to hurt—big-time. “My leg just blew out. I stopped running and could barely walk,” she recalls. “I hobbled home in pain.”

Kennelly, a writer from Berea, Ohio, was suffering from iliotibial band syndrome, one of the most common overuse injuries among runners. Because the most notable symptom typically is swelling and pain on the outside of the knee, many runners mistakenly think they have a knee injury.

But it’s not the knee, it’s the ligament that runs down the outside of the thigh from the hip to the shin. “When the band comes near the knee, it becomes narrow, and rubbing can occur between the band and the bone. This causes inflammation,” says Freddie H. Fu, M.D., a Pittsburgh orthopedic surgeon and chairman of the board of the Pittsburgh Marathon.

ITB syndrome can result from any activity that causes the leg to turn inward repeatedly. This can include wearing worn-out shoes, running downhill or on banked surfaces, running too many track workouts in the same direction, or simply running too many miles. Un many overuse injuries, however, ITB pain afflicts seasoned runners almost as much as beginners.

“Forty percent of the runners we see for ITB syndrome have been running 5 or more years,” says John Pagliano, D.P.M., a sports-medicine podiatrist in Long Beach, California, and a onetime 2:26 marathoner. “That’s quite a high number. About 50 percent of them are running between 20 and 40 miles a week.

“Also ITB syndrome is much more common in women,” Dr. Pagliano notes. “Why? It could be the way some women’s hips tilt, which can cause their knees to turn in.”

Some experts believe that the incidence of ITB syndrome has increased among all runners in recent years, although the reasons aren’t clear. “It could be because so many runners have ramped up their mileage for marathons before they’re ready to handle the distance,” says Stephen Pribut, D.P.M., a Washington, D.C., sports podiatrist.

Dr. Pagliano describes most runners with ITB pain as “Type A’s.” “They run high mileage,” he says. “They’re not willing to back off, and they are willing to run through pain.”

How can you tell if you have ITB syndrome? “The best way is to bend your knee at a 45-degree angle. If you have an ITB problem, you’ll feel pain on the outside of the knee,” says Dr. Fu. “Sometimes an MRI can confirm it. An X-ray is usually negative, but an MRI can show a partial thickening of the band—which results from inflammation.”

Here are some steps you can take to prevent ITB syndrome:

  1. Most importantly, always decrease your mileage or take a few days off if you feel pain on the outside of your knee.
  2. Walk a quarter- to half-mile before you start your runs.
  3. Make sure your shoes aren’t worn along the outside of the sole. If they are, replace them.
  4. 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.)
  5. Don’t run on concrete surfaces.
  6. When running on a track, change directions repeatedly.
  7. Schedule an evaluation by a podiatrist to see if you need orthotics.
  8. Avoid doing any type of squats.

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—85 percent—once they rest, the pain doesn’t come back,” Dr. Pagliano says. “But I’m not talking about the guy who finally decides to rest after feeling pain for 6 months during 90-mile weeks. You have to rest immediately.”

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 running.

Side stretches will also help, as will ice or heat, ultrasound, or electrical stimulation with topical cortisone. This last method is useful “particularly in the acute phase,” says Dr. Fu.

If you don’t give yourself a break from running, ITB syndrome can become chronic. “Then you’ll need to run fewer miles and give up marathons,” says Dr. Fu.

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,” Dr. Pagliano says.

Your last resort is surgery. “Once you’ve tried everything else, and nothing helps, we can surgically release the IT band,” Dr. Fu says. Adds Dr. Pagliano: “But surgery makes your knee a little floppier, and patients are never happy with it.”

As Laura Kennelly reports, “I’ve had other injuries since—including fractured bones in my foot—but none of them took as long to heal or still troubles me as much as that ITB strain. I know now that I have to respect that weakness in my leg, and back off when it acts up.”


How to Banish IT Band Pain for Good

Iliotibial Band Syndrome: How To Prevent And Treat This Common Running Injury

In October 2011, months after a seventh-place finish at the IAAF World Championships, two-time U.S. 5K champion Lauren Fleshman was training for the New York Marathon when she felt a twinge of pain in her knee.

Fleshman figured she could dial back her training for a few weeks and wait for the pain to subside. “I didn’t want to take any real time off, though,” she says.

“I ended up racing the marathon on it and really screwed it up.”

Fleshman was feeling the familiar torment of IT band syndrome, a sharp outer-knee pain that afflicts everyone from once-a-year charity 5K runners to world-class marathoners. She spent the next ten months after New York nursing the ligament in preparation for running the 2012 Olympic Trials. “If the IT band hurts, you’ve got to take it seriously,” Fleshman says.

But not every runner has access to Olympic-caliber doctors. So we talked to Fleshman and other experts to give you the best advice we can about this common but totally preventable running injury.

What Is IT Band Syndrome?

The iliotibial band, as it’s formally called, is a fascia—or fibrous tissue that connects, stabilizes, and protects muscles and internal organs. It runs from the outside of the pelvis to the lower knee and inserts into the top of the shinbone.

This do-it-all band acts as a hip abductor (helping with movement away from the body), assists with hip adduction (movement toward the body), and stabilizes the knee while running. Un a muscle, the IT band is not particularly malleable—it’s more a leather belt than a rubber band—and it’s packed with nerves, which explains the intense pain of lying sideways on a foam roller.

When the IT band becomes tight or inflamed, it creates friction as it rubs against the outer portion of your upper tibia, which causes pain on the outside of the knee.

This is different than pain on the front of the knee, which could be patellofemoral pain syndrome, commonly know as runner’s knee, and is most commonly caused by overuse. “Think of the IT band as a violin string rubbing along the side of your knee,” says Dr.

Jordan Metzl, sports medicine doctor and author of Running Strong. “If that string is stretched too tightly, it starts to get irritated over time, and that’s when you get IT band syndrome.”

What Causes It?

While IT band syndrome is often classified as an overuse injury, a variety of individual elements can irritate the temperamental tissue, says Mike Maciejewski, an athletic trainer at the University of Michigan’s Sports Medicine and Physical Therapy MedSport program.

These can include leg-length discrepancies, excessive pronation, muscle weakness in the glutes and hips, hamstring weakness, and a host of other strength deficiencies.Runners training for a marathon are especially susceptible to the injury, Metzl says.

This is most ly due to the combination of high mileage and unvaried pace.

That’s what happened to Fleshman, who hypothesizes that her IT band issues were a combination of running on slushy, uneven winter road conditions in Eugene, Oregon, and the repetitive cadence and increased mileage of ramping up marathon training. “For 5K training, you do tempos, faster intervals, speed work, and dynamic strengthening in the gym. You go through different knee and hip angles,” she says.

How Do I Know If I Have It?

Initially, runners may not feel pain until they’re miles into their workout. This factor differentiates IT band syndrome from another common knee injury—a lateral meniscus tear—which will hurt immediately.

“IT band syndrome tends to get gradually worse if you don’t fix what’s happening,” Metzl says.

The pain will be specific to the outside of the knee and may induce sharp pain and a grinding sensation as the tissue fails to adequately insulate muscle from bone.

The injured leg will ly feel tighter and more restricted than the opposite leg, and the pain will happen progressively earlier in the run as the IT band continues to tighten and inflame.

While the pain may go away with self-care and rest, that may not be enough—it can persist for weeks and even months. And you may notice symptoms outside of your workouts.

Maciejewski says patients often report pain while lying in bed on the affected leg and while crossing their legs. Morning knee stiffness is common.

Because the band is stretched most while the leg is bent, sitting may be equally painful and can actually exacerbate the injury.

If the pain doesn’t go away shortly after it arrives, it might be best to stay away from training. “It tends to get gradually worse if you don’t fix the reason why it’s happening,” Metzl says. “In the beginning, it may come on mile six or seven, then mile two, then you can’t run more than ten minutes.”

How Do I Cure It?

Training through an IT band injury can aggravate existing imbalances and cause additional injuries.

Employ any number of these at-home remedies to fix your aggravated IT band, but if it still hurts after a few months, see a doctor, ideally one who specializes in running injuries, a sports medicine doctor, orthopedic surgeon, physical therapist, athletic trainer, or podiatrist. “The clinician needs to evaluate the entire kinetic chain in order to peel back the layers to the root of the problem,” Maciejewski says.

Foam roller: Lay sideways on a foam roller and roll back and forth from the top of the knee to the bottom of the hip. Metzl recommends runners do this each day for two or three minutes on each side to break up the tightflesh—or for as long as you can tolerate the excruciating pain.

Deep tissue massage: Have a masseuse press their fingers deep into the IT band, stripping the tissue along the “gutters,” or linear indentations between tissues, and massaging the tight tissue. Maciejewski prefers this method of active release therapy because he believes it targets the specific problem areas and tends to be (slightly) less painful than foam rolling.

Lacrosse ball massage: If you’re unable to get a deep tissue massage, try this quick substitute: Lay sideways on your elbow you’re doing a side plank, then cross your top leg over your bottom leg to partially support your weight.

Place a lacrosse ball underneath your butt, just below the hip, and gently lower yourself onto the ball.

When the muscles stop spasming—and they will—roll forward (toward your hip flexor) or backward (toward your gluteus medius) and repeat until the spasms cease.

Shorten your stride: When your stride is too long, you stretch the IT band beyond its healthy limit and risk injury. Metzl recommends runners maintain a cadence of 180 steps or more per minute.

Check your terrain: To decrease the load on your knees, run on soft and flat surfaces, smooth dirt trails. If you must run on pavement, avoid hilly and uneven routes to lessen the pounding.

Foot support: Excessive pronation can load the outside of the knee and strain the IT band. Switch out your shoes after 500 miles, and consider heading to a local running store or athletic trainer for a gait analysis. The pros can identify whether your current shoes are supportive enough.

Sit less: If you hit the showers and go straight to an office job, you’re not doing your IT band any favors. Desk jockeying keeps the IT band stretched and sedentary, which may increase inflammation and pain. Fleshman swapped her chair for a standing desk to expedite the healing process.

R.I.C.E.: Use this popular treatment progression—an acronym for rest, ice, compression, and elevation—as a supplemental rehabilitation tool. Take time off running and apply an ice pack to the painful area, wrap tightly with an Ace bandage, and elevate for ten minutes. Do this two or three times each day for best results.

Take time off: Runners are habitually greedy about their daily endorphin rush and sense of achievement, but a few days or weeks of rest could pay massive dividends down the road.

Fleshman took three weeks off after the New York Marathon to heal her disgruntled IT band but says that was “not even close to enough time.

” She stayed fit with short walk/sprint intervals and swimming workouts and still made the 5K final at the 2012 Trials.

Stretch: A few key stretches can loosen up the tissue surrounding the less malleable IT band. Start with the standing IT band stretch: place your right foot behind you and to the left of your body while reaching over your head and to the right with your right hand. Chase it with the brettzel, the glute stretch, and the hamstring stretch to round out the routine.

How Do I Prevent ITBS?

Strength deficiencies, especially in the glutes, are the common culprit of repeated IT band syndrome injuries. “The stronger your butt muscles are, the better your running life will be,” Metzl says.

Do these killer glute and core strengthening exercises three times a week to build a rock-solid kinetic chain and kick IT band syndrome for good.

Plyometric jump squats: Start with a regular body squat (back straight, weight over your heels), but explode upward into a jump and land with your knees bent, starting the next squat without hesitation. Metzl recommends four sets of 15 squats.

Single leg squats: Stand on one leg while holding the other leg in front of you at a 45-degree angle. Squat down as deeply as possible while still being able to come back up. If you can’t make a 90-degree angle with your plant leg, place a bench underneath you and tap it at the bottom of the squat to help you stand back up.

Glute bridge: Lay on your back with your knees bent past 90 degrees and digging your heels into the ground. Thrust your hips upward until your torso and quads form a straight line and hold that position for two seconds while squeezing your glutes. Do two or three sets of 15.

Leg raises: Lay on your side with your hips tucked under your stomach (as opposed to pushing your butt outward) and your legs straight. Squeeze your glutes while raising your top leg 15 times.

Then cross your top leg over your bottom leg and raise your bottom leg 15 times. Finally, sit upright and raise each leg 15 times while squeezing your quad to lock out the knee.

That’s one set; repeat two or three times.

Clamshells: Lay on your side as you would with leg raises, but tuck your legs into a 45-degree angle (with your knees bent 90 degrees).

Squeeze your glutes and raise your top knee while touching your top foot to your bottom foot—it should look just a clamshell.

Do these 15 times on each side for two or three sets, and up the ante by slipping a rubber band around your knees to add resistance.

Planks: These are remarkably effective for maintaining upright running form and keeping a quiet core, which makes you more efficient and takes the pressure off your knee. Hold for one minute on the front and one minute on each side (hands or elbows). Start in front of a mirror to lock down perfect form.


Iliotibial band syndrome: Symptoms, exercises, and treatment

Iliotibial Band Syndrome: How To Prevent And Treat This Common Running Injury

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People who exercise regularly, particularly runners, are prone to experience pain in the outer part of the knee. When this occurs, iliotibial band syndrome may be the cause.

Iliotibial (IT) band syndrome is often caused by repetitively bending the knee during physical activities, such as running, cycling, swimming, and climbing.

The IT band is a group of fibers that run the length of the upper leg, from the hip to the top of the shin.

When overused, the IT band can become tightened. The tightening can cause the band to rub against the outside of the knee. The rubbing can lead to pain and swelling.

IT band syndrome may begin as mild pain and intensify if left untreated. The best treatment is often to stop doing the activity that is causing the pain. In more severe cases, surgical options may need to be considered.

Share on PinterestIliotibal band syndrome may cause pain around the knee, during or after exercise.

Symptoms of IT band syndrome may vary slightly from person to person in intensity and how they appear.

Some symptoms include:

  • pain when running or doing other activities involving the outside of the knee
  • a clicking sensation where the band rubs against the knee
  • lingering pain after exercise
  • the knee is tender to touch
  • tenderness in buttocks
  • redness and warmth around the knee, especially the outer aspect

Symptoms typically begin a short time after starting the physical activity.

The most common symptom of IT band syndrome is pain on the outside of the knee that gets worse if the person continues the activity causing the pain.

As a person continues to run or participate in a similar activity, the IT band will continue to rub against the outside of the knee, leading to swelling and severe pain.

IT band syndrome is often relatively easy to treat. There are two main types of treatment for the condition:

  • reducing pain and swelling
  • stretching and preventing further injury

Some of the most common ways to treat IT band syndrome include:

  • resting and avoiding activities that aggravate the IT band
  • applying ice to the IT band
  • massage
  • anti-inflammatory medications, which are often available over the counter
  • ultrasounds and electrotherapies to reduce tension

The most important treatment is to stop the activity that causes the pain altogether. Resting for up to 6 weeks will typically allow the leg to heal fully.

Share on PinterestIf any stretches cause pain or significant discomfort, they should be stopped immediately.

Anyone who runs enough can develop IT band syndrome. However, there are some stretches and exercises that help both prevent and treat the condition.

People should aim to do a combination of stretching and specific exercises that focus on the IT band. Some of these exercises and stretches are described below.

Glute stretch

This stretch is easy to perform.

  • lay flat on the back with one leg outstretched
  • lift the leg and, holding the leg at the shin, pull the knee toward the midsection
  • gently pull the leg until feeling a stretch
  • hold the stretch for a few seconds

Standing stretch

This stretch should be felt on the outer muscles of hamstring.

  • stand with both feet together
  • while holding the supporting leg, place one foot behind and just past the other foot
  • lower the body, bending at the supporting knee

Foam roller stretch

This exercise helps massage out and gently stretch the tight IT band.

  • place a wide foam roller on the ground or a yoga mat
  • using the forearm for support, lay sideways on the roller
  • with the roller positioned under the hip, move the body forward so that the roller moves up and down the leg as far as the knee

Foam rollers are widely available to purchase from sports stores and online.

Standing or lying hip abduction

In the standing position:

  • stand with both legs together
  • lift one leg to the same side away from the center
  • repeat with both legs

In the lying position:

  • lay on the side and lift the leg into the air
  • repeat 10 to 15 times on each side.

A person may add a weight or resistance band to their stretching as they get stronger, which are also available online.

Hip abduction machine

People with access to a gym may be able to use a piece of equipment that targets the hip abductors, the muscles that move the leg out away from the body. Stretching these muscles can help treat and prevent knee pain.

The machine requires the user to sit with their legs together, their knees bent, and their feet on the footrest.

The machine has pads attached to a weighted pulley system designed to sit on the outside of the legs just above the knees. The person then opens their legs, pressing against the machine’s resistance

Training modifications

A person who has experienced IT band syndrome may want to speak to a physical therapist to identify ways in which they can modify the way they run or perform other exercises.

Training modifications may include:

  • using inserts for shoes to correct foot arch collapsing
  • slowing any increases in running distance
  • avoiding running on sloped surfaces
  • avoiding downhill exercise

Things to avoid

A person with IT band syndrome should immediately stop any activity that is causing symptoms. Often, this means no running, as well as avoiding cycling, long flights of steps, and other activities that involve bending the knees.

When getting back into these activities, people often need to ease themselves back in slowly, to help avoid the syndrome from coming back.

Runners should always increase the distance of their runs gradually.

Share on PinterestA physical therapist or personal trainer may diagnose IT band syndrome by performing an Ober’s test.

Physical therapists and trainers can often tell whether a person has IT band syndrome. For those people who are not working with one of these specialists, a family doctor can also diagnose the problem.

To determine whether a person has IT band syndrome, a healthcare professional will ly talk to the person about their symptoms. They will need to know when the pain began and what activities cause the pain.

The doctor or other healthcare professional will then ly perform the Ober’s test. For this test, the person lies on their pain-free side with the bottom knee and hip at a 90-degree angle. The doctor or physiotherapist will steady the pelvis and then lift the affected leg. They then bring the hip back toward the ground.

A person tests positive for IT band syndrome when there is less than a 10-degree angle from the natural horizontal position.

The healthcare provider will also watch how the person stands and walks to check for pronation of the foot. They will also look for tightness in the upper leg muscles and hips.

A tight iliotibial band is the main cause of IT band syndrome.

When working normally, the IT band will glide across the outside of the knee over a fluid-filled sac called a bursa. If the IT band becomes too tight, the band will rub against the knee, causing friction, swelling, and pain.

Some people may be more prone to developing IT band syndrome than others. Some factors that can increase a person’s risk include:

  • running on uneven surfaces
  • rolling of the foot while running
  • a difference in leg length
  • poor running form
  • naturally tight or wide IT band
  • weakness in the hips
  • flattening foot or rolling when running
  • not stretching enough

A person with IT band syndrome should see a full recovery once they have stopped the offending activity for a while.

People can reduce risks of being re-injured through stretches and exercises that both strengthen the legs and keep them less tight.

Once rested and healed, a person should be able to return to their preferred activity, though easing back in gently is a good idea.


What Is Iliotibial Band Syndrome?

Iliotibial Band Syndrome: How To Prevent And Treat This Common Running Injury

If you’ve got a nagging pain on the outer part of your knee, especially if you’re a runner, it could be a symptom of iliotibial band (IT band) syndrome. It’s an injury often caused by activities where you bend your knee repeatedly, running, cycling, hiking, and walking long distances.

Your IT band is a thick bunch of fibers that runs from the outside of your hips to the outside of your thigh and knee down to the top of your shinbone. If your IT band gets too tight, it can lead to swelling and pain around your knee.

IT band syndrome usually gets better with time and treatment. You don’t typically need surgery.

The problem is friction where the IT band crosses over your knee. A fluid-filled sac called a bursa normally helps the IT band glide smoothly over your knee as you bend and straighten your leg.

But if your IT band is too tight, bending your knee creates friction. Your IT band and the bursa can both start to swell, which leads to the pain of IT band syndrome.

Several things can up your odds of getting it. Some you can help, and others you can’t.

Not using the right training techniques.

  • Not doing enough to stretch, warm up, and cool down
  • Pushing too hard — you go too far or for too long
  • Not resting long enough between workouts
  • Wearing worn-out sneakers

Running or training on the wrong surfaces.

  • Running downhill
  • Running only on one side of the road. Because roads slope toward the curb, your outside foot is lower, which tilts your hips and throws your body off.
  • Training on banked, rather than flat, surfaces. Most running tracks are slightly banked.

Certain physical conditions. Some traits raise your chances of getting IT band syndrome:

  • Bowed legs
  • Knee arthritis
  • One leg that’s longer than the other
  • Rotating your foot or ankle inward when you walk or run
  • Rotating your whole leg inward when you walk or run
  • Weakness in your abs, glutes, or hip muscles

The main symptom is pain on the outer side of your knee, just above the joint. Early on, the pain might go away after you warm up. Over time though, you may notice it gets worse as you exercise.

Other symptoms include:

  • Aching, burning, or tenderness on the outside of your knee
  • Feeling a click, pop, or snap on the outside of your knee
  • Pain up and down your leg
  • Warmth and redness on the outside of your knee

See your doctor if you have these symptoms, especially if any existing ones get worse.

Typically, your doctor can tell you have IT band syndrome your symptoms, health history, and a physical exam. It’s not the only cause of outer knee pain, so you may get an X-ray to rule out other causes.

If you closely follow your doctor’s orders and give yourself the rest you need, you can usually recover from it in about 6 weeks.

Some basic steps can help ease the pain and swelling:

  • Don’t do activities that trigger the pain.
  • Take over-the-counter pain relievers.
  • Wrap an ice pack in a towel and put it on the outside of your knee for 10-15 minutes at a time.

A physical therapist can:

  • Give you tips for how to best warm up and cool down
  • Help you choose footwear and, if you need them, shoe inserts
  • Show you exercises to help strengthen and stretch your IT band and leg muscles
  • Talk to you about how to adjust your training schedule
  • Teach you how to improve your form to go easier on your body
  • Use friction massage, ice, or ultrasound to help with pain and swelling

That usually does the trick, though some people need cortisone injections to help with pain and swelling.

To help prevent IT band syndrome, you can:

  • Allow plenty of time to properly stretch, warm up, and cool down.
  • Give your body enough time to recover between workouts or events.
  • Run with a shorter stride.
  • Run on flat surfaces or alternate which side of the road you run on.
  • Replace your shoes regularly.
  • Stretch your IT band, hip muscles, thigh muscles, and hamstrings often.
  • Use a foam roller to loosen up your IT band.


Hospital for Special Surgery: “Iliotibial Band (IT Band) Syndrome.”

Houston Methodist: “Iliotibial Band Syndrome.”

UC San Diego Health: “Iliotibial Band Syndrome.”

Emory Healthcare: “IT Band Syndrome.”

University of Wisconsin Health: “Iliotibial Band Friction Syndrome and Greater Trochanteric Bursitis.”

Rice University: “Iliotibial Band Friction Syndrome.”

Nicholas Institute of Sports Medicine and Athletic Trauma: “Iliotibial Band Friction Syndrome Treatment.”

National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Knee Problems.”

St. Luke’s Health System: “Treatment for Iliotibial Band Syndrome.”

Medscape: “Physical Medicine and Rehabilitation for Iliotibial Band Syndrome Treatment & Management.”

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