What is iliotibial (IT) band syndrome? Causes, treatments, and exercises
Learn how movement and physical therapy helps manage iliotibial band (IT) syndrome and get recommended exercises from physical therapists.
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Ever experienced an aching or sharp pain on the outside of your knee or hip after a workout or an afternoon of chores? This could be a sign of a tight iliotibial (IT) band. Your iliotibial band is a long band of fascia (a sheath of connective tissue that supports every part of your body including muscles, tendons, ligaments, and organs) that extends from your hip to just below the outside of your knee, attaching to the outside of your kneecap.
Since your IT band is hard at work as you move throughout the day, it’s common for the fascia to get irritated. Just because this type of irritation has a formal name — iliotibial band syndrome — doesn’t mean it’s serious or something to be especially worried about, says Samantha Charlotin, PT, DPT, a physical therapist at Hinge Health.
Simple moves like strengthening and stretching the IT band, as well as self-massage, can help so that you can get back to your activities without IT band pain.
Read on to learn more about iliotibial (IT) band syndrome, what causes it, and how to treat it, especially with exercises and stretches from Hinge Health physical therapists.
Reviewed by our clinical and medical experts
Samantha Charlotin, PT, DPT
Jonathan Lee, MD, MBA
Dylan Peterson, PT, DPT
What is iliotibial band syndrome?
Iliotibial band syndrome occurs when the IT band gets irritated or inflamed. “When you bend and extend your leg, your IT band moves over the outer edge of your thigh bone,” explains Dr. Charlotin. If you’re doing this frequently with a repetitive activity such as running, this movement may irritate nearby tissues and cause discomfort.
Anyone can develop IT band syndrome, but it’s often seen in athletes like runners and cyclists, says Dr. Charlotin. But if you play any sport intensely — whether it’s soccer, basketball, or even skiing — you may notice it too.
Symptoms of iliotibial band syndrome
IT band syndrome symptoms include:
Lateral knee pain. This is pain on the outside of the knee. It can be aching and/or burning. “Since your IT band wraps around the lateral part of your knee, it can cause discomfort there,” explains Dr. Charlotin.
Clicking, popping, or snapping sensation on the outside of the knee.
Hip pain. Pain can involve your knee as well as from your thigh to your hip. This is because the IT band runs from the pelvis to just below the knee and also crosses the hip.
Causes of iliotibial band syndrome
There are a few reasons why your IT band might get irritated or tight. Some iliotibial band syndrome factors include:
Your muscles. If you have any issues with your hip abductor muscles (tightness or weakness), these can contribute to IT band pain because your knees rotate inward to compensate, putting strain on the IT band, says Dr. Charlotin.
Running on a tilted surface. If your body isn’t prepared, this type of running can put more strain on your IT band, especially if you are running downhill. So this is something your body may need to get used to. As your legs and hips become stronger and more resilient, your IT band may not get as irritated in these situations.
Changes in your movement routine. A sudden increase in running mileage, for example, can cause your IT band to become inflamed. The same is true if you begin to add hills into your workouts. All this means is you’re doing a little more than your body is ready for. It takes time for your body to adapt to any activity. This may be especially true for people who are new to an activity, points out Dr. Charlotin.
It’s important to remember that there may not be just one factor contributing to IT band syndrome. Rather than focusing on one potential cause, Dr. Charlotin recommends that you listen to your body. If it hurts to do an activity, scale back until it doesn’t bother you as much, then gradually ramp up again.
Treatments for iliotibial band syndrome
Most of the time, iliotibial band syndrome can be treated conservatively at home. One study in the Journal of Sports Medicine found that people who did a combination of stretching and strengthening exercises, pain management, and modified activities (for example, reducing their running frequency) saw their symptoms improve by 44% after two to six weeks. Some of the iliotibial band treatments Hinge Health physical therapists recommend include:
Modify activity. Dr. Charlotin recommends that you take a break from any activities that cause IT band pain. “Movement is still very much recommended, but some period of reduced activity may also be needed so that you can heal,” she explains. If you’re a runner, for example, you may want to switch to a week or two on the bike, or even do pool running, which can be gentler. “These are good activities to keep up your cardio, so that you can resume your original activity once pain has subsided,” she says.
Ice massage. Ice massage will help to stretch out the fascia and surrounding muscle. You can apply ice to the affected area that hurts for 10 to 15 minutes, several times a day.
Over-the-counter (OTC) pain relievers. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for IT band pain. It’s important to make sure that you are safely able to take these medications, based on your medical history. Another option is a topical NSAID, such as diclofenac (Voltaren), or pain relief creams like Icy Hot, says Dr. Charlotin.
Foam rolling. A physical therapist can teach you how to use a foam roller to massage the entire IT band. “Many people just perform self-massages in the immediate area where they feel pain, but the IT band itself feeds into the tensor fasciae latae (TFL) muscle that sits lateral at the hip, so you need to focus on that entire area too,” explains Dr. Charlotin.
Exercises for iliotibial (IT) band syndrome
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- Knee Rocking
- Hamstring Stretch
- Banded Side Lying Leg Raises
- Clam Shells
- Bridges
- Knee Extension
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The above exercises are recommended by Hinge Health physical therapists to strengthen the IT band, hip, and leg muscles. “Stretches can help get your whole hip moving and elongate it,” explains Dr. Charlotin. “You’ll also want to strengthen your lateral hip and knees to take pressure off that area.”
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
PT tip: Keep your core and lower body strong
You can continue to run and do the activities that you love while healing your IT band, but make sure that you add in strengthening sessions for your core and lower body. “The stronger these surrounding muscles, the better your stability and mechanics, and the easier it will be to transfer force down your leg,” advises Dr. Charlotin. This way, there will be less strain on your IT band.
"It's made a huge difference in strengthening the muscles that support knee function. I am so grateful. As a result I have been able to resume running after a year off for recovery from torn meniscus. Since Hinge Health I am now able to run 3 miles a few times a week, with longer runs mixed in. Great progress after being told I'd never run again due to the injury and arthritis and worn down cartilage."
How Hinge Health can help you
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
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Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
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This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
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References
Hadeed, A., & Tapscott, D. C. (2020). Iliotibial Band Friction Syndrome. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK542185/
van Poppel, D., van der Worp, M., Slabbekoorn, A., van den Heuvel, S. S. P., van Middelkoop, M., Koes, B. W., Verhagen, A. P., & Scholten-Peeters, G. G. M. (2020). Risk factors for overuse injuries in short- and long-distance running: A systematic review. Journal of Sport and Health Science, 10(1). doi:10.1016/j.jshs.2020.06.006
Beals, C., & Flanigan, D. (2013). A Review of Treatments for Iliotibial Band Syndrome in the Athletic Population. Journal of Sports Medicine, 2013, 1–6. doi:10.1155/2013/367169
Jackson, J. (2023, March 15). Iliotibial band syndrome. UpToDate. https://www.uptodate.com/contents/iliotibial-band-syndrome