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What is IT Band Syndrome?

For me, the pain of “IT” (iliotibial) band syndrome began while I was out for a 12-mile run. I had been running happily for miles when I suddenly felt pain on the outside of my knee. I tried to continue running, but a mile later I had to stop and walk. 

Now, as a physician assistant, many of the patients I see with IT Band injuries initially believe their knee pain comes from a twist or some other acute injury during their run.  Although IT Band injuries come on quickly, they are typically the result of an existing muscle imbalance as opposed to an acute injury. 

How IT Band Injuries occur:

  • The IT band is a big band that runs from the top of the hip to the outside of your shin bone. It crosses from the side of your hip down to the outside of your knee.
  • When running, your knee and foot placement need to be stabilized side to side. This is done by the muscles that move your hip.
  • The gluteus medius muscle supports this hip movement.
  • When the gluteus medius and other hip muscles are weak, you overuse smaller muscles that are not typically utilized for major movement (like the tensor fasciae latae or TFL) to stabilize and move your feet.
  • These smaller muscles pull really hard on the IT band, which causes it to tighten where the band crosses the outside of the knee.
  • When the IT band gets tight it causes inflammation and then pain.

Symptoms of IT Band Syndrome include:

  • Pain on the outside of the knee
  • Sudden pain during a run
  • Consistent pain - once the pain flares up on a run, every run after can be painful
  • Pain is worse when going up or down stairs or other elevation

Strengthening hip and gluteus medius muscles can reduce your chances of getting IT band injuries. Personally, I found foam rolling as a helpful modality for my IT band injury, however, there are theories out there that foam rolling can aggravate an already inflamed IT Band.

My best advice for runners who have suffered from IT band issues in the past or present is to seek out a physical therapist.  There is a lot of trial and error with addressing IT bands. A physical therapist can quickly identify muscle imbalance and weakness and develop a treatment plan based on strengthening and stretching to more quickly get you back to running pain-free.

Matt Dobler, PA-C, is a physician assistant with OrthoCarolina Huntersville and a former athletic trainer. He was a competitive cross country runner in college at UNC Charlotte.


Medical Massage and Neuromuscular Massage are also very effective in treating ITB syndrome. You just have to find a Massage Therapist that is knowledgeable in Therapeutic massage, not just spa treatments.
- David turner
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