IT Band StretchRunning is a fantastic exercise for cardiovascular health, but there are certain injury risks associated with the activity. One potential injury runners can sustain is iliotibial band syndrome. Fortunately, there are preventative measures you can take to reduce your risk and keep you safe while on your favorite running courses.

The Iliotibial Band

The affected tissue is the iliotibial (IT) band. This is a tendon attaching hip muscles (including the tensor fascia latae) in the upper leg to the outer side of the tibia in the lower leg. The tensor fascia latae is the muscle that allows the leg to move outward.

The IT band narrows as it travels towards the knee, ultimately anchoring to the outside of the tibial plateau (found on the top of the tibia. The band’s fibers extend over to the patella (kneecap).

Iliotibial Band Syndrome (ITBS) Causes and Symptoms

In most cases, the primary symptoms of ITBS are swelling and pain on the outside of the knee. For this reason, many runners think they have sustained a knee injury. Try bending your knee to a 45-degree angle and paying attention to any pain on the outside of the knee. If pain is present, it’s likely you have a problem with your IT band. For an accurate diagnosis, you may need to have an MRI performed.

This particular injury is often caused by activities that force the leg to repeatedly turn inward. Running can constitute such an activity on account of pronation. Pronation is a normal biomechanical process the foot goes through with every step. It is an inward rolling motion of about fifteen percent performed between the heel strike and final push off of the toes. If you have low foot arches (flatfoot), you likely overpronate, which means your inward roll is greater than the fifteen percent. This could potentially lead to ITBS.

Other running-related causes of ITBS include running in worn-out shoes, running on banked surfaces or downhill, running in the same direction for too many track workouts, or even simply running too many miles. This is an overuse injury, but unlike other overuse injuries it affects veteran runners almost as much as newbies. Women are more likely to experience the injury than men, which can be explained by the fact women’s hips tilt in a different manner that causes the knees to turn inward.

Treating ITBS

Upon recognizing pain on the outer edge of your knee, the best practice is to take time off from running. If you continue to run and try “pushing through” it, the condition can become chronic. Immediate rest can prevent the pain from coming back.

During your break from running, you may wish to do some cross-training with low-impact activities like cycling, rowing, pool running, or swimming.

In addition to rest, you may also benefit from ice and heat, side stretches, electrical stimulation, and ultrasound therapy. Cortisone injections can break up any scar tissue on the IT band and also speed the healing process. That said, cortisone can weaken connective tissues and should be reserved as a “second-to-last resort.”

The final resort when it comes to iliotibial band syndrome treatment is surgery to release the IT band.


Here are some measures you may wish to use in order to prevent iliotibial band syndrome:

  • Before you run, walk between a quarter and a half mile to warm up.
  • Replace your running shoes when they are worn down.
  • If possible, run in the middle of the road. That section tends to be flatter, but you will need to find roads with excellent visibility and little or no traffic.
  • Don’t run on concrete surfaces.
  • Change directions repeatedly when running on a track.
  • If you feel pain while running, either decrease your mileage or, even better, take some time off to rest.
  • Schedule an evaluation with McDowell Orthopedics & Podiatry Group to see if you need orthotics.

Complete Foot and Ankle Care in Carmichael, CA

For more information on iliotibial band syndrome, or any foot or ankle sports injury causing you difficulty, simply give us a call at (916) 961-3434. While on the line, you can request an appointment with our Sacramento, CA office.

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