Running with IT Band Pain – A Guide to Recovery

8 miles in to my 16 mile run a slight burning around my knee turned in to a stabbing pain, that had me sitting on the sidewalk gulping back the tears. This was in the age before you took your cell phone everywhere or even Googled every injury to it was a tight IT Band Syndrome.

I hobbled 8 miles home, sniffling, cussing and wondering what the heck just happened.

Thus began my first foray in to working with sports medicine Dr’s to try and resolve and issue.

Luckily, this doctor immediately identified my issue as IT Band pain after running, due to having increased both mileage and pace too quickly. Plus, never, ever warming up. DOH, I’m so much smarter now.

Unluckily, this is one persistent problem.

I spent the next few years in a cycle of it’s better, sigh “no it’s not”.

Then I did what I do best.
Research.
Test.
Talk to TONS of experts.

In this article, I’ve covered everything there is that you need to know about this injury and how to fix IT Band syndrome long term

What is IT Band Syndrome?

Without getting to sciencey on you, the IT Band muscle is not a muscle at all. You can now be the smarty pants in your group when you explain, the IT Band is connective tissue that runs from your hip to your knee.

As the IT Band gets tight it begins to rub on insertion points creating knee pain.

The IT Band provides essential support for the outer hip in moving and standing upright. Which is why there are a number of things that could cause it to become tight!

Consider the IT Band a bit like acne, it’s where your body gives you a signal that you’re doing something wrong.

You didn’t clean your make up off before bed (do your hip strength work), you’re eating foods your body doesn’t like (massive changes to your running routine), or you’re using the wrong products (you’re form sucks).

Symptoms of IT Band Issues

The most common and obvious is outer knee pain while running.

It usually comes on suddenly and sharply for most runners, then often seems to stop if they begin to walk. Appearing again when they try to run…until we keep pushing it and it hurts all the time.

• Outside of knee (where IT Band connects) – primary pain point
• Along the outside of your leg
• A the top of your hip (where the IT Band connects)

According to Dr. Sarah Ceschin, PT, DPT, almost all runners report pain along the outside of the knee if they have IT Band issues. This is because the IT Band inserts on the lateral portion of the tibia (at Gerdy’s Tubercle – ain’t that a fun name!).

As the knee goes through flexion/extension, it is common for the ITBand to rub against the lateral femoral or tibial condyles causing friction and leading to inflammation of the band itself and of the underlying bursa.

IT Band injuries can cause pain near the lateral hip area as well; however, this is less common than at the insertion point along the outside of the knee joint. 

Do you need to rest with IT Band Syndrome?

No and yes.

No rest will NOT resolve ITB issues.

Yes, if you are to the point of hobbling home like I was you need to stop.

But more importantly you need to find the cause and then do the hip, core and glute work to not only help it now, but prevent it from returning. Keep reading to get all the details on what will help you resolve the pain long term.

Can you run with IT Band Syndrome?

IT Band Syndrome will only get worse over time.

You can’t run through it.

You must address the cause and take care to resolve it before it sidelines you! What might start as a quick sharp pain that goes away will morph in a full leg pain that makes it hard to walk.

Trust me, you don’t want to be the dumb runner I was in 2007.

IT Band exercises and stretches to eliminate the pain once and for all! A must read for runners #runchat Share on X

Causes of IT Band Syndrome

The root cause of ITBS can be anywhere from the hip to the knee, so it might be tricky to pinpoint the exact cause. But let’s look at the top ones quickly so that you understand better how to resolve the injury.

If you’re looking for a more in-depth guide, go over this and more in my 80-page Ultimate IT Band Solution e-book.

It will help you determine not only the root cause, but also what you can do for a full recovery. It includes exercises and tips to implement immediately for relief!

1. Overuse

Like I said above, IT band syndrome is typically an overuse injury. As we bend and extend our legs, the IT band glides over the upper thigh bone and top of the shinbone.

Repeating these motions again and again, over time can lead to tightness in the IT Band. This explains why it’s a common worry for runners.

As this tissue becomes tighter and tighter, friction starts happening as it rubs on bones. This rubbing motion leads to irritation and, ultimately, inflammation that manifests as intense and quite persistent pain around your knee or hip.

2. Tight Tissues

Another cause can be tight muscles in your hips or along the side of the leg.

Since all these tissues are connected, even if the pain manifests in or around the knee, it could very well be that your hips is what requires the most attention.

Muscles can get tight from a variety of things:

• Sitting all day long
• Standing or sitting with poor posture
• Tightening from being overworked or poor form

PRO TIP: Do NOT foam roll right along your IT Band >>

BONUS TIP: 5 IT Band Stretches (that also work your hips) >>

3. Skipping the Warm Up

My personal pet peeve with runners.

This is a game changer in preventing IT Band pain. Yes, seriously it’s that important!

A few minutes of dynamic stretching is a great place to include some of the much needed hip and glute work. Consider this, 10 minutes before your run to prevent months of time off dealing with pain…fair trade.

See a full dynamic warm up >>

4. Weak Glute Muscles

For many runners, particularly females, we tend to become quad dominant and overtime the reliance on our stronger muscle means that we stop utilizing our gluteal muscles (aka your ass).

If the brain stops telling the glutes to engage while you run, eventually your gait changes and boom…your IT Band starts to hurt.

Scientifically speaking “Average hip abductor (Glute medius) torque in 24 distance runners with ITBS was found by Fredericson et al (2000) to be significantly weaker than that of the uninjured limb and controls.”

Short hand…work your butt out, not off.

When the muscles in your glutes aren’t strong enough, it affects your running form. This in turn puts a lot of stress on the tissues in the knee as your knee tends to fall inward, which is going to pull on that IT Band.

For this reason, strengthening glute muscles is incredibly important to preventing IT band syndrome from ever occurring in the first place, especially for runners.

5. Poor Running Form

Often, the leading cause of an IT band syndrome can be poor running form, particularly overstriding or crossing the body with your arms.

In this way, by just correcting your running form you could very well help resolve this injury.

If you feel your running form might be contributing to this problem, you might want to check out my Running Technique Program. I go over the exact drills you need that will improve your form and help prevent injuries from occurring in the first place.

6. Too Much, Too Soon

Did you start adding too many miles or too much speed work too fast? That’s one of the most common causes of ALL running injuries.

Remember that this isn’t the time to expect overnight progress.

• Try sticking to the 10% weekly increase rule
• Start with hill repeats before speed work – makes you faster and doesn’t stress the ITB
• Remember to work on cadence for speed, not a longer stride
• Slow progress is still progress, while an injury forces you to start all over

IT Band Treatment Options

The next 15+ years of running, have been blissfully free of IT Band pain.

This isn’t to say it never gets tight, but now I know how to stay on top of it so that it never becomes painful or stops me from running.

With the first twinge of outside knee pain after running, I have a plan:

• Check my shoes to see if they are worn down
• Visit the chiropractor to get my hips aligned
• Redouble my hip and glute work in my dynamic warm up
• Use the heat to loosen the tight muscles

Let’s breakdown this process, along with additional steps I took to resolve it.

💡If you don’t know where to start or how to integrate hip and glute strength, checkout my 30 Day Runner Core Program. 10 minutes a day that you can add to your warm up.

How to Stop ITBS Pain?

First, while it’s tempting to do as I did and throw everything at it immediately the more common sense approach is to try a few things at a time.

This allows you to figure out what actually helped, allowing your body to adjust to the change and keep that handy for any future issues.

Download my free IT Band Checklist to get started on recovery >>

Yup, I just implied that once you’ve had IT Band pain it might comeback. BUT as I shared with my story you can change this pattern.

Second, your IT Band is not evil and does not need to be beaten in to submission.

 In fact, you really shouldn’t be using the roller right along your IT Band when it’s inflamed at all. (Read why to stop foam rolling your IT Band!) You’ll also see below the stretches you can use instead to help alleviate the tightness.

Focus on applying heat to relax the muscle and things that will reduce inflammation.

Should You Stop All Activity?

While many general doctors will tell you simply to rest, I’ve yet to see that solve things for most with IT Band issues. And my favorite Physical Therapist, Stuart Wilson of Elevate PT, says that won’t fix the issue.

In fact, most of the physical therapists or sports medicine Dr’s have agreed that rest will drop inflammation so it feels better, but it will begin to hurt again as soon as you start working out again, unless you fix the root issue.

If you’re in pain when you run, STOP!!!
If you can walk, do that instead as you recover. The walking will indeed help your running.
If you can’t walk, swim.
If you can’t swim, then you definitely need to get to a sports medicine Dr.

• First evaluate your hips to find out if you’re out of alignment
• Remember that ice is not always the solution, especially for tight muscles
• Learn how to correctly foam roll around the IT Band
• Include the below IT Band exercises
• Include consistent IT Band stretches
• Increase your hip work with resistance bands
• Strength training for IT Band recovery

1. Check Your Shoes

If you’re running in shoes that are worn down, it will in fact change your gait. That means changing how your foot lands on the ground and then how the rest of your leg reacts.

It often results in your foot and knee rolling inward. But it could also mean your hips aren’t staying level, so one leg it always doing more work.

2. Compression Shorts IT Band

One of the tools that helped me continue running marathons when figuring out the lasting solution to IT Band issues were compression tights.

I LOVE the CW-X Stablyx tights because of the bands that provide serious support along the IT Band.

If you hate running in compression, there are still benefits to pull it on after your run to increase blood flow to the area and help your hips, glutes and IT Band to relax.

3. Commit to the Core Work

Don’t want to deal with this ever again?

Warm up and do core, hip, and glue work all the time.

Seriously, 5 minutes pre-run is going to make all the difference in preventing a ton of injuries, but especially this one.

4. Try Foam Rolling

You want to release anything that might be pulling on your IT band, so this means foam rolling your tight TFL, tight calves, quads, hamstrings and glutes.

Best Exercises for IT Band Pain

You can’t relax the IT Band, that’s a fallacy.

It’s tissue, not a muscle. so you can’t stretch it out, you can’t lengthen it and you can’t fight it.

What you can do is strengthen other areas so that your IT Band isn’t taking a beating for their weaknesses, poor form or from sitting all day.

In this video you’ll find some of my favorite IT Band exercises, which you can start doing daily right now. If you’re in pain, many of these will still be doable and help you to work through it.

As you get back to running, continue using these in your pre-run warm up. And make that warm up a PRIORITY!

The best part of these exercises to relieve IT Band pain is that they address all kinds of normal runner issues.

Movements to help hip pain, glute pain and knee pain are all rolled in to these.

I don’t know about you, but double duty makes me happy.

There you have it, everything a runner needs to understand about how to treat IT Band Syndrome and put it in your review mirror. If you want even more of my tips and favorite moves, I’ve compiled it in to an easy to use eBook.

Have any other tight IT Band questions?

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