The Ilio-tibial band (IT Band) is a thick fibrous structure that runs from the outside of your hip down to the side of your thigh to the outside of your shin bone. The purpose of the IT band is to bend the hip and knee and to help control the knee position while we walk and run. 

Who gets IT band pain?

  • People new to running (novice runners),
  • Runners who are training for a particular event and have recently increased their training load,
  • Generally males more than females. 
  • Trail runners are at higher risk (because of the narrow step width while running on trails). 
  • People who run downhill a lot (downhill running increases the compression force on the outside of the knee).

And why? 

  • IT band pain happens as a result of a training load error. If you increase the volume of training too fast, ie by increasing the distance of your runs too fast, or increasing the number of runs you are doing a week, when the body is not ready for the extra load it can result in injury.
  • IT Band pain is an overuse injury that causes pain on the outside of the knee when running because of high compressive forces and inflammation. 

What does it feel like?

  • Pain usually starts gradually as a nagging dull ache on the outside of the knee.
  • It may come on when you start to increase your training load, either by doing longer runs or doing more sessions a week. 
  • You may be pain free on short runs but pain appears on longer runs.

Is IT Band pain from the band being too tight?

No. The IT Band needs to be ‘tight’ for it to do its job. Stretching the IT band will not reduce pain or help with healing. The injury occurs as a result of increased training load when the body wasn’t ready for it. It is an overuse injury.

How is IT Band pain treated?

  • Firstly, we need to reduce pain levels. This can be done by taking some rest from training and/ or changing your training load so it doesn’t flare up pain. Ice can be used to reduce inflammation at the knee along with anti-inflammatory tablets if needed.
  • If treated early you could continue training by slowly increasing your training load and addressing other factors that may have caused it (using advice from a Physiotherapist). 
  • However, if the cause isn’t treated or the pain is ignored you may need to stop running for some time to reduce pain levels.
  • You may need to add in strengthening exercises for the hip, knees, ankle and trunk. If there is muscle weakness in these areas it can place higher demand on surrounding structures which can result in overuse injuries like IT Band pain. 
  • You can maintain your cardio fitness using a cross trainer or treadmill. Uphill treadmill walking is good for people with IT Band pain as it doesn’t place as high a load on the outer knee while also allowing you to work on fitness.
  • Gradual return to running can take place once your pain levels are under control, your strength in surrounding joints has improved and the cause of the injury has been identified and treated appropriately. 
  • Return to running needs to be controlled and progressive so the injury doesn’t reoccur once you resume running. 


Should I foam roll the sore area at the outside of my knee?

  • No. IT band pain is a result of increased compressive forces on that area. By foam rolling the sore area you are compressing the injured area further, which will cause more pain.
  • If you regularly foam roll you can continue doing the other areas, just avoid foam rolling the sore area on the outside of the knee. 

Talk to one of our Chartered Physiotherapists if you think you may have IT Band pain. They can help you figure out the cause of the injury, treat it and guide you back to training safely.

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