IT band pain keeps tons of runners off the road and cyclists off their bikes. Learn how to combat the pain with ITB stretches for improved mobility and pain-free movement.
Iliotibial (IT) band syndrome is a common problem for runners. As many as 15 percent of runners are thought to deal with the issue, which causes pain on the outside of the knee.
And runners aren’t alone in this honor – other athletes, particularly cyclists, also regularly face IT band issues .
The pain starts gradually at first. You might notice a slight ache that starts to show up on the outside of your knee after longer runs.
But the pain intensifies over time, progressing until it really starts to hamper your workouts, maybe even preventing you from hitting the track or trail at all .
Usually, people just take it easy until the pain eases up. But IT band syndrome is persistent, and more often than not, the ache comes right back once you start training again.
To prevent this frustrating cycle, let’s learn a little bit more about the anatomy of the issue, then we’ll talk about a few strategies that will effectively address it – not just delay the symptoms temporarily.
IT Band Anatomy
Your IT band is a thick band of tissue that lies on the lateral side of your upper leg. It runs down from your tensor fasciae latae and your gluteus maximus, and is connected to the iliac crest of the pelvis.
The band travels down your leg, connecting to both the femur bone of your upper thigh and your tibia (shin bone) as it runs along the outside of the knee.
Your IT band works to stabilize your knee while also helping flex your hip via the action of the tensor fascia latae .
Where your IT band meets your femur, there is a bony bump called the lateral epicondyle. The connection between this bony bump and this band of tissue is often the source of ITB troubles.
When these two structures rub together (as may often occur repetitively in activities like running and cycling), friction can occur.
In fact, at certain parts of the running cycle, there is a perfect storm of factors that can contribute to ITB issues.
When your foot is striking down and your knee is flexed at about 30 degrees, your glute max and TFL tense up to decelerate your leg, causing tension in your IT band as it rubs past the lateral epicondyle .
The rubbing starts to cause irritation, and before you know it – you’ve got IT band syndrome and lateral knee pain.
The lateral knee pain of ITB syndrome is often felt right on your lateral epicondyle. However, it may be felt slightly above or below this bony landmark.
Running or a similar repetitive leg movement, like cycling, will trigger and aggravate the pain, and certain factors, like running downhill may make the pain worse .
IT band syndrome may also cause pain when you bend or straighten your knee – even if you aren’t doing so repetitively.
Because it’s appearance is tied to a tensed IT band rubbing against the outside of the knee, ITB syndrome often goes hand in hand with a tight IT band. And tightness in your IT band may itself be related to other issues, including low back pain .
In short – when IT band pain shows up, don’t ignore it. Address it!
A Serious Stabilizer
Earlier I mentioned that the IT band helps provide stabilization to the knee. But there’s reason to examine this more closely
Usually, the first line of defense against ITB syndrome is static stretching. But thanks to it’s knee-stabilizing role, overly stretching your IT band may do you more harm than good.
Your IT band helps provide knee stability when your tibia internally rotates. This internal rotation happens a lot during cut or pivot movements – think about a soccer player cutting around other players on the field to control the ball.
When this type of motion doesn’t come from a stable or supported position, serious injuries like ACL and PCL tears can occur.
And studies have shown that the ITB provides a TON of stabilization for internal rotation , supporting these oft-torn cruciate and collateral ligaments of the knees.
So what does this mean?
Well for one, it means that keeping your IT band healthy won’t just help prevent the nagging pain of IT band syndrome and related issues like low back pain – it could even go a long way to preventing major knee injuries that require surgery and months of recovery.
But it also means that you don’t want to overstretch the IT band. It is a crucial stabilizer of your knee, so you want to keep it just that – stable. Over-aggressive static stretching of the ITB could only lead to much bigger problems down the road.
Root Causes of ITB Syndrome
We’ve learned that excess tension and friction in the IT band and surrounding structures leads to the pain and irritation of IT band syndrome. Now it’s time to consider the ROOT causes of all this excess stress.
Otherwise (as is all too often the case), we’ll just hear “tension” and think of solving it with static stretches. Which as we’ve seen, may be a recipe for knee instability.
So instead, let’s consider how our body mechanics and habits are leading to the pain.
There is one culprit that is behind a vast majority of ITB syndrome cases: poor running mechanics.
For example, one study found that male runners with IT band syndrome had a variety of mechanical issues with their run – including greater internal rotation of the hips, greater adduction of the knee, and weaker external hip rotators when compared to runners without IT band issues .
What do these factors mean for your run? Tendencies related to these deficiencies, like excessive stride length and excessive heel strike, might make you more prone to IT band pain .
And one other factor that can also make IT band issues worse? Simple overuse.
Don’t jump headfirst into a running training plan without building up your distance gradually. Adding on the miles before your body’s ready can not only contribute to IT band-related knee pain, but also issues like shin splints and peroneal tendonitis.
3 ITB Stretches
Now that we know what we’re dealing with, let’s get ready to combat the pain with a couple of focused ITB stretches.
Static: SB Side Stretch
I’ve included this static stretch because it is a highly effective way to stretch the entire lateral line of your body – including your IT band.
BUT, you must remember not to overuse this stretch! Take it easy, don’t be too aggressive with this move, and don’t rely on ONLY this static approach (make sure you continue to the next 2 dynamic moves)!
- Lay on your side on a swiss ball, with your feet planted along the base of a wall for stability
- With straight legs, start to lay over the ball
- Reach your top arm over your head and try to relax
- Breathe consciously into the top side of your body as you relax into the stretch
- Hold for about 30 seconds, then switch sides
Watch Video: Click here to watch the SB Side Stretch video
Open chain dynamic: Lateral Leg Swings
This next move is a dynamic open chain stretch that accomplishes a lot. This technique will challenge your balance and strengthen your lower body all while providing a nice stretch of the ITB as you move your leg across your body.
- Plant your right hand on a wall and reach your left hand directly out to the side
- Start to swing your left leg across and in front of your body (towards the right)
- Feel a nice IT band stretch before swinging the leg back toward the left and kicking up, using your extended left hand as a target
- Be sure to point your toes up as you swing your leg out to the left, generating some rotation in the leg
- Repeat several times and switch sides
- If you feel comfortable, you can try this technique without using the wall for support
Watch Video: Click here to watch the Lateral Leg Swings video
Closed chain dynamic: Reverse Crossunder Lunge & Reach
This next stretch is a closed chain dynamic technique that provides a nice ITB stretch while also improving the coordination and power of your entire lower body. Pay attention to your breath during the move, as it can help deepen the stretch.
- Prepare to come in to a lunge with your right foot forward, and your left foot behind you.
- Instead of a traditional lunge stance, cross your left foot behind your right, which will deepen the ITB stretch
- As you step back into the lunge, start to reach your left hand up and over toward the right side
- Return to the start and switch sides
- Keep alternating sides, inhaling as you reach up and stretch, exhaling as you move to the other side
Start to incorporate these ITB stretches into your routine, and you should start to see some effective, lasting relief of IT band pain.
But while these drills will help, we’ve learned that IT band syndrome involves a whole lot of factors. Because of this, you must address the entire kinetic chain – these ITB stretches will help with flexibility and mobility, but alone they won’t fix your poor running mechanics, for example.
So consider how your body is functioning as a whole and try to address imbalances, poor techniques, and overtraining habits. Combine full-body strategies like these with the stretches described above.
This holistic approach should both ease your current pain AND address the root cause of ITB pain – helping to prevent it from coming back and keeping you from tying up those laces and hitting the road.