Shoe Or Orthotic Issues
You can correct every issue in your body, but if what comes between your foot and the ground is the cause of your problem, youll never see relief. Overworn shoes can cause your foot to land at awkward angles, which transfers a lot of stress up to the knee and hip, so keeping your shoes within their recommended mileage is critical. Also, adjusting to minimalist shoes will require you to adjust your running style, so be sure to do your research and be patient while adjusting. Finally, arch or ankle problems may require you to get orthotics so you can run with a safer gait.
With all of these suggestions, you can expect for improvement to take some time. If your pain lingers for longer than a few weeks, it may be time to talk to a healthcare provider for some more individualized treatment.
Can This Injury Or Condition Be Prevented
Maintaining core and lower-extremity strength and flexibility and monitoring your activity best prevents ITBS. It is important to modify your activity and contact your physical therapist soon after first feeling pain. Research indicates that when soft tissues are irritated and the offending activity is continued, the body does not have time to repair the injured area. This often leads to persistent pain and altered movement strategies, and the condition becomes more difficult to resolve.
Once you are involved in a rehabilitation program, your physical therapist will help you determine when you are ready to progress back to your previous activity level. They will make sure that your body is ready to handle the demands of your activities so that your injury does not return. You also will receive a program to perform at home that will help you maintain the improvements that you gained during rehabilitation.
How Can A Physical Therapist Help
Your physical therapist will use treatment strategies to focus on:
Range of motion. Often, abnormal motion of the hip, knee, and foot joint can cause ITBS because of how the band attaches to hip muscles. Your physical therapist will assess the motion of your involved leg compared with expected normal motion and the motion of the hip on your uninvolved leg.
Muscle strength. Hip and core weakness can contribute to ITBS. The core refers to the muscles of the abdomen, low back, and pelvis. Core strength is important, as a strong midsection will allow greater stability through the body as the arms and legs go through various motions. For athletes performing endurance sports, it is important to have a strong core to stabilize the trunk and pelvis during repetitive leg motions. Your physical therapist will be able to determine which muscles are weak and provide specific exercises to target these areas.
Manual therapy. Many physical therapists are trained in manual therapy, which means they use their hands to move and manipulate muscles and joints to improve motion and strength. These techniques can target areas that are hard to treat on your own.
Your physical therapist also will work with you to develop an individualized treatment and training program specific to your personal goals. They will offer tips to help you prevent your injury from recurring.
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How Do I Prevent It Band Pain
You can prevent IT band irritation by:
- Replacing your workout shoes when they no longer feel supportive
- Running in both directions if running on an uneven course or on a track
- Stretching before and after working out
- Increasing your workout intensity over time
- Training on flat surfaces
- Limiting running or jogging downhill
It Band Syndrome Causes And Risk Factors

When you flex and extend your knee, the IT band rubs over the thighbone and causes inflammation. When the IT band is inflamed, it doesn’t glide easily. This can be painful.
People at risk of IT band syndrome, or hip bursitis, are those who suddenly increase their activity level of activity, such as runners who increase their mileage.
Mechanical problems in your gait are also a main cause of IT band syndrome.
These include:
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Whats In The Name Of A Syndrome
IT band syndrome is a syndrome because the pain is unexplained. We dont know the specific mechanism, so we dont give it a name that implies a specific cause .
All syndromes are simply descriptions of an unexplained but distinctive pattern of symptoms. Most syndromes involve patterns of symptoms with a lot of variation, but the pattern of ITBS is more simple and specific: pain on the side of the knee, related to overuse, notably aggravated by descending stairs and slopes. Its only unexplained insofar as no one has actually figured exactly what tissue gets into trouble.)
Prefer a video explanation? I have a video tour of the big three IT band myths, including this one. :
Could It Band Syndrome Be The Cause Of My Hip Pain
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IT band syndrome is caused by overuse, and is common in endurance athletes like runners and bikers. It affects the tissue that runs from the side of your hip all the way down past your knee. Most of the time, the inflammation manifests itself as pain on the outside of the knee, but can leave you with a deep aching in your hip. Researchers have found that weak hip muscles can be one of the biggest reasons why people get IT band syndrome. Usually, hip weakness contributes to faulty movement patterns over time, the tightness of the IT band increases.
When your knee flexes and extends, the IT band rubs over the thigh bone and causes inflammation. When the IT band is inflamed, it doesn’t move easily, causing pain. It can be a difficult injury to heal and take a long time to overcome. Here are some helpful tips that can prevent IT band syndrome and help you to heal.
4 Helpful Tips:
Resolving your IT band syndrome can be as easy as changing the way you run. Find a professional to look at your running gait utilizing their expertise can help fix your running mechanics to get to the root of the issue. If your pain lingers for longer than a few weeks after trying the above-mentioned tips, it may be time to talk to a healthcare provider for more individualized treatment.
For an in-depth evaluation of your hip and knee pain, please give us a call at 872-4477.
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Other Pain Locations And Types That Are Not It Band Syndrome
Pain on any other part of the thigh or hip is the most common kind of pain mistakenly attributed to ITBS, but it is definitely something else even if it is partially related to the iliotibial band, its still not IT band syndrome. Greater trochanteric pain syndrome is the appropriate label for most unexplained hip and thigh pain. More about GTPS below.
The other big red herring is anterior knee pain: patellofemoral syndrome, the other common kind of runners knee, is a more imprecisely defined condition than ITBS. More on this one below as well.
Posterior knee pain has several possible causes, like popliteal artery entrapment syndrome , popliteal or biceps femoris tendinopathy.
Knee pain that is hard to locate diffuse pain is definitely something else. ITBS is not hard to locate! Diffuse knee pain may be arthritic in character, related to a spinal issue, a stress frature, or meniscal damage. Diffuse pain is tricky to diagnose, but its not ITBS.
Another source of lateral knee pain is a lateral meniscal tear. Its usually traumatic, with pain a little too low and too deep for ITBS, and usually accompanied by other signs and symptoms like swelling, locking, clicking, and clunking.
So What Does Cause Hip Pain
Nothing is mistakenly called ITBS more often than hip and thigh pain, which can be just as stubborn and baffling as ITBS. Calling it ITBS implies that it has something to do with the IT band, when in fact this kind of pain has many and likely overlapping causes.
Obviously there are a lot of possible causes of hip pain, but greater trochanteric pain syndrome is the most useful and accepted label for unexplained hip-o-centric pain: aching with an epicentre around the large bump of bone on the side of the hip, the greater trochanter of the femur. While it is usually experienced as mainly hip pain, it routinely involves widespread, diffuse pain throughout the entire region and into the thigh.
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How To Treat It Band Pain
You can start with good stretching.
Try this stretch, which is the best for IT band stretching, according to Dr. Laskowski.
Stand near a wall or a piece of sturdy exercise equipment for support. Cross your left leg over your right leg at the ankle. Extend your left arm overhead, reaching toward your right side. You’ll feel a stretch along your left hip. Hold for about 30 seconds. Switch sides and repeat.
“In addition to stretching, a foam roller can be helpful to massage the IT band, increase blood flow and provide some element of loosening to the tissue,” says Laskowski. .
But stretching isn’t the most important thing. It’s all about strength-training for your hip muscles to help stabilize the leg and prevent inward rotation of the knee.
Laskowski suggests doing hip abduction walks with resistance tubing to work the hip muscles. The hip abduction walk targets the hip abductor muscles on the outside of the hips. This exercise trains the hip abductors to work as stabilizers, which is how they’re used in daily life. Keep your knees slightly bent during the exercise, keeping your steps smooth and controlled as you feel the tension along your outside leg and hip. Move lateral side to side until your form begins to fail. The switch to frontward and backward steps.
“Strength training should be performed 2 to 3 days per week keep an off day between working the same muscle groups. You should start to see some gradual improvement over a period of 4 to 6 weeks,” says Dr. Laskowski.
What Is It Band Syndrome
The IT band is a thick band of fibrous tissue that runs along the outside of your leg. It starts at the hip and extends to the outer side of the shinbone just below the knee joint.
The IT band works with the muscles in your thigh to provide stability to the outside of the knee joint.
IT band syndrome also called hip bursitis or greater trochanteric bursitis happens when the IT band becomes too tight. This can cause friction at the top of your hip or near your knee, resulting in inflammation.
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Lots More Reading About It Band Syndrome
These are all of the free excepts from my book about IT band syndrome available on PainScience.com. Its a lot, but its only about 20% of the entire book.
Or just start reading the free introduction to the IT band syndrome book. If you find the free content useful, consider buying the book, or a donation to support user-friendly evidence-based publishing.
Did you find this article useful? Interesting? Maybe notice how theres not much content like this on the internet? Thats because its crazy hard to make it pay. Please support independent science journalism with a donation. See the donation page for more information & options.
Exercises That Can Help With It Band Hip Pain

It is important to understand that the location of the pain is not always where the problem is. Too often, I see people focus too heavily on the location of the pain. This can actually make the pain even worse by aggravating an already sensitive area .
But the location of the pain can provide insight into our pain patterns. If we are concerned about the IT Band, we should start investigating that area of the body.
We learned that the IT Band is a tendon and does not respond well to stretching and foam rolling. But what structures around the IT band can we manipulate better? Muscles! And the muscles around the IT band are some of the strongest and most powerful muscles in the body.
If the muscles that surround the IT Band are weak, stiff or otherwise restricted, how will this feel? What will this do to our hip and other joints? It can cause discomfort. It can cause stiffness. And it may certainly cause sensations of pain.
The below sections are broken down by muscle. These are the main muscles that surround the IT Band. Ill provide an exercise that tests the muscle’s ability in a certain movement. Ill also provide a minimum intensity of reps and hold time that I think most beginners should be able to accomplish.
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How Common Is Iliotibial Band Syndrome
Experts note that iliotibial band syndrome often affects U.S. Marines during training. More than 20% get iliotibial band syndrome. Frequent runners, especially long-distance runners, are also prone. Iliotibial band syndrome accounts for about 12% of running injuries. More females than males have iliotibial band syndrome.
Knee pain of which iliotibial band syndrome is one of many causes affects as many as 25% of adults.
Laying It Band Stretch
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Physical Therapy Guide To Iliotibial Band Syndrome
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Iliotibial band syndrome, or ITBS, is one of the most common overuse injuries of the leg, particularly in individuals involved in endurance sports. It accounts for up to 12% of running injuries and up to 24% of cycling injuries. ITBS is typically treated through physical therapy and a temporary change in activities. Physical therapists help people with ITBS lessen pain, restore movement, and return to activities and sport.
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.
How Can You Prevent Future It Band Pain
The root cause of IT band pain is often weak gluteal muscles or leg muscles or poor walking posture with an uneven gait. Exercises focused on strengthening these trouble spots may prevent future injury. Prevention.com recommends healing exercises to strengthen and loosen the surrounding muscles such as these exercises.
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It Band Pain Exercises For The Tfl Muscle
The tensor fascia latae is a muscle located on the outside of the pelvic bone and inserts into the iliotibial tract near the greater trochanter at the outside of the hip. The TFL helps to stabilize the hip and knee, performing several functions including: internal rotation, flexion, and abduction of the hip and lateral rotation of the knee.
A great TFL stretch for IT band tightness can be performed as follows:
When stretching alone isnât enough to help, you may consider releasing the TFL first by applying direct pressure to the muscle using a lacrosse ball. Hereâs how you do it:
Key Points About Iliotibial Band Syndrome
- Iliotibial band syndrome causes pain on the outside of your knee.
- It often happens in athletes, especially distance runners. But anyone can get it.
- Using incorrect sporting equipment and having a poor running stance may increase your chance of having this condition.
- Most people respond to treatment such as pain medicines, ice, stretching, and strengthening exercises, and limiting the activity for a while.
- Some people may need surgery to treat the condition.
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Other Remedies That Might Help With Itb Syndrome
There are several complementary therapies you can use to treat ITB syndrome. Decide which ones are most useful to your routine and incorporate them into your exercise program. Here are some to consider:
- Sports or deep tissue massage. A professional massage tailored to prevent and recover from injury can improve flexibility, ease muscle tension, and reduce muscle spasms.
- Myofascial release. This type of physical therapy uses massage to relieve pain, tension, and tightness in your myofascial tissues.
- Acupuncture. This treatment may help relieve pain and discomfort as you heal from an IT band injury.
- Hot and cold therapy. These simple treatments can help alleviate pain and inflammation, though they may not completely heal the cause of your discomfort. Use a heating pad, or take a hot bath or shower, to warm up and relax your muscles. Use an ice pack to reduce pain, swelling, and inflammation. Alternate between methods every 15 minutes, or do one at a time.
- NSAIDs. To relieve pain and inflammation, take nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen , or naproxen . Only use these drugs on a short-term basis.
- Healthy choices. Follow a healthy diet with plenty of fresh fruits and vegetables. Stay well hydrated by drinking plenty of water and indulging in healthy drink options, such as coconut water, vegetable juice, and herbal teas. As long as they dont interfere with any of your medications, take herbal supplements that can reduce pain and inflammation.