IT Band Syndrome

If you’re training for a marathon, half-marathon, or 5K, you’ve likely encountered aches and pains. Most of this is normal as you push your body out of its comfort zone.

However, certain injuries can put a wrinkle in your training. Learn about IT band syndrome, a common yet often painful condition that can affect runners.

What Is IT Band Syndrome?

IT band syndrome is an irritation of the iliotibial (IT) band — a tight band of tissue that connects the butt muscles to the knee. The iliotibial band isn’t a tendon (which attaches muscle to bone) or a ligament (which attaches bone to bone). It’s a band of facia — fibrous tissue.

The iliotibial band runs along the outside of your leg, starting at the hip and extending to the outer side of the shinbone just below the knee joint. When it’s too tight, it can cause friction either at the top of your hip or down by your knee.

Overuse of this group of muscles can often lead to a condition called IT band syndrome. People will usually say their hip hurts, but when they point to where it hurts, it’s directly on the side of their leg, not near the hip joint.

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What Causes IT Band Syndrome?

IT band syndrome results from repetitive improper use, especially during knee-bending activities like running, cycling, and hiking.

Some of the factors that contribute to its development include:

  • Poor training methods. Not varying running routes or always running on hard surfaces can increase stress on the IT band. Also, failure to adequately rest when increasing activity intensity or duration places excessive strain on IT bands.
  • Muscle imbalance. Hip abductor muscle weakness and tightness around thigh areas can expose iliotibial bands to stress.
  • Inappropriate footwear. Wearing the wrong shoes for specific sports may cause misalignment. This can subject these structures to undue pressure and result in IT band pain.
  • Biomechanical problems. Some people have abnormalities. These include differing leg lengths, excessive inward rolling of feet while walking or running (excessive pronation), and bowlegs. These may increase the risk factors associated with developing this condition.

Symptoms of IT Band Syndrome

With IT band syndrome, people sometimes complain of their hips feeling hot and looking red. The side of their hip bones may also feel sore to the touch.

In addition, they might feel a clicking or rubbing sensation on the side of their knee. This condition is often very painful and will most likely hurt more if you try to run through it.

What does an irritated IT band feel like?

An irritated IT band usually feels like a sharp or burning pain on the outside of your knee. Sometimes, you might feel it along your thigh up to your hip.

This pain typically worsens with running or cycling, especially when going downhill or climbing stairs. It might feel mild at first and then worsen if you keep up the activity that triggered it.

What happens if you leave IT band syndrome untreated?

Left untreated, pain can get worse and last longer. It might start affecting your daily activities, not just exercise.

Over time, using the irritated IT band without treatment can lead to more severe injuries in your knees or hips. This is because you might start moving differently to avoid the pain. That action can strain other body parts, potentially leading to additional problems or injuries.

IT Band Syndrome Treatments

You can try various home treatments to address IT band syndrome and reduce pain and inflammation.

Home treatments for IT band syndrome include:

  • Rest. Refrain from activities that cause pain, especially those involving repetitive knee movements such as running or cycling.
  • Strengthening and stretching exercises. Perform exercises that strengthen and stretch specific muscles to improve the affected IT band’s flexibility and support. These can include standing IT band stretches or exercises that strengthen hip abductors.
  • Rolling out the IT band. Use foam rollers on the outer thighs, which help relieve tightness around IT bands and reduce tension within them.

When to See a Doctor for IT Band Syndrome

You should see a doctor for IT band syndrome if you have:

  • Pain that doesn’t improve with rest and home treatments. If you’ve tried resting, icing, and over-the-counter pain relievers but your symptoms haven’t improved after a week or two, see a physician or physical therapist.
  • Severe pain. If the pain feels intense enough to keep you from your regular daily activities, get medical advice to avoid making things worse.
  • Pain during the night. Consult a specialist if the pain keeps you awake at night or if you experience severe discomfort while resting.
  • Swelling. Significant swelling around the knee or along the IT band that doesn’t go away with icing and rest means it’s time to seek help.
  • Locking or clicking. If you feel a locking or clicking sensation in your knee that makes it feel unstable, see a medical provider to rule out other potential issues.

During a medical evaluation, expect the doctor to perform specific tests and ask about your activity levels and symptoms.

Tests a provider may run to diagnose IT band syndrome include:

  • Pressing along the IT band to identify areas of tenderness.
  • Moving your leg and knee through various motions to check for pain.
  • Assessing flexibility and strength.

They may suggest imaging tests or refer you to a specialist if home management strategies fail to alleviate your symptoms.

About Sports Medicine

An athletic lifestyle carries the potential for injury. Whether you’re an elite athlete or a weekend warrior, UPMC Sports Medicine can help. If you are looking to prevent, treat, or rehabilitate a sports injury, our multidisciplinary team of experts can help you get back into the game. If you are seeking to improve your athletic performance, we can work with you to meet your goals. We serve athletes and active people of all ages and experience levels. Our goal is to help you keep doing what you love. Visit our website to find a specialist near you.