One of the most common and frustrating injuries for runners is IT band syndrome or iliotibial band syndrome(ITBS). Running with IT band pain can be difficult or impossible depending on how severe it gets. If you are a runner that is having this problem then this post should tell you everything you need to know.
ITBS is the pain on the outside of the knee caused when the IT band becomes irritated and inflamed. If you are suffering from this don’t worry it doesn’t have to keep you from running long. I had problems with IT band pain before I learned how to treat it. Since then I haven’t had any further problems. I hope the information in this article can help you as well.
What is Iliotibial Band Syndrome
The iliotibial band is a thick band of fascia that runs from the outside of the pelvis, over the hip, along the outside of the knee, to the top of the shin. This band isn’t a muscle or a tendon and doesn’t stretch like one. It’s primary job is to connect and stabilize the muscles and structure of the leg and knee.
If your IT band becomes stiff or agitated it can begin to rub against the outer part of your upper tibia. This will cause friction, pain, and irritation.This can happen quickly, but not immediately like a tear or sprain.
Symptoms and Diagnosis
The initial symptoms of ITBS are usually minor and often overlooked. The pain will increase over time and can be bad enough to prevent walking or climbing stairs. This pain can be misdiagnosed as a more serious running injury. The most accurate way to tell the difference is to have an MRI but usually, a physical examination is enough to make a diagnosis.
There are a few clues when you have IT band pain and not a more serious injury. In typical cases, IT band pain will develop gradually over time. When rested the pain fades quickly and can go away completely. When you start to run it will take several minutes for the symptoms to start to return.
In comparison, a serious knee injury won’t stop hurting after a day’s rest and will begin hurting immediately when stressed. Of course, it is always best to be safe. We recommend talking with a health professional whenever you have any kind of injury.
Note: If you are having knee pain and it isn’t on the outside of your knee then it isn’t IT band syndrome. If you are having shin splints then please read this post on running with shin splints.
There are many causes for IT band pain and most can be easily corrected. The most common are running gait, lack of flexibility and/or strength (especially in the hips and lower back), running on a sloped/uneven surface, running on stairs, your running shoes, or over-training. Anatomical or genetic issues may also cause you to be predisposed to IT band problems.
Once symptoms start to show it is important to diagnose the cause and work on correcting it right away. If left untreated scarring can occur and ITBS can become chronic. Since there are so many possible causes it might take a bit of trial and error to get fixed. Hiring a running coach or getting physical therapy can help diagnose the cause.
Not Just For Runners
This article is about running with IT band pain but I wanted to point out non-runners can get this as well. It isn’t as common but hikers, cyclists, and people who recently had knee surgery can also get IT band syndrome. I didn’t want anyone coming away from this article thinking that non-runners couldn’t have this problem.
Treatment of IT Band Pain
It is important to emphasize that the only way to solve IT band pain is to resolve the cause. Normally that will consist of buying proper shoes, alternating your running route, or correcting your running mechanics. Working on strength and flexibility is also important.
Other than that it is important to understand that IT band syndrome is considered to be an overuse injury. That means that the standard rest, ice, compression, elevation (R.I.C.E) treatment will be best. You could also add and anti-inflammatory medication to help with pain and swelling.
Outside this treatment, the focus needs to be on resolving the core issue causing the problem. Once that has been determined exercises and stretches that are focused on that can be added. Most of the time a few weeks or months is all it takes to recover.
For some unfortunate runners IT band syndrome can be very stubborn and very resistant to treatment. When I was having my IT band pain it lasted over a year. Every time I thought it was fixed it would come back. Don’t give up and keep working on it and eventually you will find what works.
Prevention of IT Band Pain
IT Band Strap
I was given one of these when I was dealing with my IT band pain and it worked really well. Even after I was able to run without pain I still wore it when I played basketball or did squats. This is really the only product I could recommend for ITBS. If you browse Amazon you will find other products for IT band pain but I have never heard of any of those working.
Weakness in your glutes, core, lower back, legs, and hip muscles can cause IT band pain. That is because those muscles all play a part in the mechanics of walking and running. Any weakness or imbalance can cause problems that affect the IT band. Addressing those and bringing everything back in balance can therefore correct the problem.
There are a lot of exercises that will help strengthen those muscle groups. Since describing exercises with text is difficult I have found a video that shows some good examples. If you don’t know where to begin I recommend getting with a personal trainer or physical therapist. Together you can come up with a workout plan that addresses your personal needs.
There are a lot of stretches that are recommended for IT Band pain but most won’t do much. That’s because the IT band is a thick band of tissue that can withstand a huge amount of force. I have seen it described as being like a leather strap.
Since you cant stretch the IT band directly you need to focus on the muscles that feed into it. There are several muscles that feed into the IT band. By stretching those you can in effect stretch the IT band. I can’t find any actual studies that indicate that this is effective so I’ll defer to the experts.
Treatments That Don’t Work For IT Band Pain
If you google around your going to find a lot of treatments for IT band pain that don’t work. Or at least don’t work well enough for the discomfort they cause. I have done these for my IT band so this gives you a chance to learn from my pain.
Deep Tissue Massage
A lot of runners swear by deep tissue massages for relieving IT band tightness. In my personal experience, deep massage hurt like hell and only gave me a little relief. That relief only lasted until my next run. If you are having persistent IT band pain while running it might be worth trying to see if it helps you but it didn’t help me.
Honestly, it makes perfect sense that massage won’t be helpful. The IT band is really thick and tough. There is no way you can apply enough pressure to have any effect. Well, besides hurting really badly.
I love foam rolling and use my foam rollers all the time. Still, I don’t recommend using a foam roller for your IT band. There are two problems. First, it hurts almost as much as the tissue massage. Second, the IT band doesn’t respond to this kind of treatment. If deep massage with your hands isn’t going to be enough no foam roller has a chance.
Running with IT Band Pain
Finally we get back around to answering the most important question. Can you run with IT band pain? You will be happy to know that most of the time running during treatment is going to be just fine. That does depend on the severity and your own pain tolerance.
If you can tolerate the pain there is likely no risk in continuing to train. You will want to take extra time to warm up and walk more than normal. When you run keep your pace slow and your strides short. When you start to feel pain stop and walk for a while. The whole goal should be to get in as much running as possible without irritating your knee too much.
When you finish take extra cool-down time and stretch. Then put your knee up with ice to reduce the swelling and pain. It is important to listen to your body and not push too hard. In the end the only thing that will happen is you will take longer to recover.
Thanks For Reading
That is all I have on running with IT band pain. I really hope that you found this helpful. Thanks so much for taking the time to read this. I appreciate it a lot. I would love to hear back from you. If you have had iliotibial band syndrome I would enjoy hearing what you did to fix it. Thanks again and have a great day!
One final thing, if you found this helpful please share it with your friends. Thanks!
- The treatment of iliotibial band friction syndrome
- The anatomy of the iliopatellar band and iliotibial tract
- Is iliotibial band syndrome really a friction syndrome?
- The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome