The IT Band Syndrome Epidemic: What Runners Need to Know About This Frustrating Injury

When Every Step Feels Like a Knife to the Knee

If you’re a runner, you’ve probably heard of Iliotibial Band Syndrome (ITBS)—or maybe you’re dealing with it right now. That sharp, stabbing pain on the outer side of your knee, the discomfort that flares up during runs but eases when you stop, the frustrating cycle of pain that just won’t go away.

IT Band Syndrome is one of the most common running injuries, yet it’s also one of the most misunderstood. Many runners push through the pain, hoping it will disappear. Others rest for a while, only to have the pain return the moment they hit the pavement again.

So, why does this happen? More importantly, how do you get rid of IT Band pain for good? Let’s break it down.

What is IT Band Syndrome?

The Iliotibial (IT) band is a thick strip of connective tissue that runs from the outside of your hip, down the outer thigh, and attaches to the knee. It plays a crucial role in stabilising the knee during movement.

IT Band Syndrome (ITBS) occurs when this band becomes tight, irritated, or inflamed, leading to pain on the outer side of the knee—especially when running or walking downhill.

Unlike some injuries that occur due to a single traumatic event, ITBS develops gradually due to repetitive strain and biomechanical imbalances.

What Causes IT Band Syndrome?

IT Band Syndrome is not simply an "overuse" injury. It’s the result of poor biomechanics, muscle imbalances, and training errors. The most common contributing factors include:

1. Weak Hip and Glute Muscles

Your glutes (buttocks) and hip stabilisers play a crucial role in keeping your knees aligned while running. If these muscles are weak, the knee collapses inward with each step, putting extra tension on the IT band.

2. Running on Sloped or Hard Surfaces

Consistently running on hills, uneven terrain, or roads with a camber increases strain on the IT band, leading to irritation.

3. Overstriding and Poor Running Form

Taking long strides or landing heavily on your heel increases impact forces and shifts unnecessary stress onto the knee and IT band.

4. Sudden Increase in Training Load

Many runners develop IT Band Syndrome after rapidly increasing their mileage, speed, or intensity without allowing the body time to adapt.

5. Tight IT Band and Surrounding Muscles

Contrary to popular belief, the IT band itself doesn’t stretch much—it’s a dense connective tissue. However, tightness in the hip flexors, quadriceps, and hamstrings can indirectly put strain on the IT band, leading to irritation.

Signs and Symptoms of IT Band Syndrome

How do you know if you’re dealing with ITBS? Here are the most common signs:

✅ Sharp or burning pain on the outer side of the knee (especially during running)
✅ Pain that worsens with activity but eases with rest
✅ Tenderness or tightness along the outer thigh
✅ Swelling or inflammation near the knee joint
✅ Discomfort when walking downhill or downstairs
✅ Pain when bending the knee at 30-40 degrees, the position where the IT band rubs against the thigh bone

If left untreated, ITBS can linger for months, making running—and even daily activities—painful.

How to Treat IT Band Syndrome Effectively

The good news? IT Band Syndrome is highly treatable with the right approach. Instead of simply resting (which often leads to temporary relief but no long-term fix), the key is to address the root cause of the problem.

1. Reduce Inflammation and Pain

🔹 Apply ice to the affected area for 10-15 minutes after running.
🔹 Use anti-inflammatory techniques like massage therapy or dry needling.
🔹 Temporarily reduce running volume to avoid aggravating the issue.

2. Strengthen Weak Muscles

Most IT Band Syndrome cases are due to weak glutes and hip stabilisers. A tailored strengthening program can correct these imbalances.

Key exercises include:
✅ Clamshells – Activates the glute medius for better hip stability.
✅ Side-lying leg raises – Strengthens the outer hip muscles.
✅ Single-leg squats – Improves knee alignment and stability.
✅ Glute bridges – Builds strength in the posterior chain.

3. Improve Running Technique

Many runners unknowingly develop inefficient running mechanics that contribute to IT Band pain. A biomechanical running assessment can identify poor habits, such as:

🚫 Overstriding
🚫 Heel striking
🚫 Poor knee tracking

Correcting these issues with proper form training can significantly reduce strain on the IT band.

4. Adjust Training and Recovery

🔹 Avoid running on sloped surfaces or excessive downhill training.
🔹 Incorporate rest and cross-training (cycling, swimming, strength training) to reduce repetitive strain.
🔹 Gradually increase mileage—no more than 10% per week.

5. Manual Therapy and Stretching

While you can’t stretch the IT band itself, releasing tension in surrounding muscles can help reduce irritation.

✅ Foam rolling the quads, hamstrings, and glutes
✅ Hip flexor and hamstring stretching
✅ Massage therapy to reduce tightness

How Physiotherapy Can Help

If IT Band pain is stopping you from running, it’s time to get professional help. At Proactive Physiotherapy, we take a comprehensive approach to treating ITBS, focusing on:

✔️ Running assessments to identify biomechanical faults
✔️ Hands-on treatment to reduce pain and inflammation
✔️ Strength and mobility training to fix underlying weaknesses
✔️ Personalised return-to-running plans to prevent reinjury

Rather than just masking the symptoms, we help correct the root cause—so you can get back to running pain-free and stronger than before.

Final Thoughts: Stop IT Band Syndrome Before It Stops You

IT Band Syndrome is one of the most frustrating injuries for runners, but it doesn’t have to be a long-term problem. By addressing the true cause—muscle imbalances, poor running form, and training errors—you can not only heal but run stronger and more efficiently than before.

Don’t let ITBS sideline you. If you’re experiencing knee pain, take action today.