IT Band Syndrome

Poor form could be the culprit in creating nagging knee pain

Feb 27, 2012
Outside Magazine

The injury:
IT Band Syndrome is often billed as the most common cause of knee pain, particularly in cyclists, runners, and hikers. The iliotibial band is made up of connective tissue and it runs from the outside of the hip to the outside of the knee, where it can rub against part of the femur and become irritated.  

How to prevent it:
Several studies, including an award-winning study published in 2007, have shown that improper form during repetitive exercises can cause an IT band flare up. People who rotate their knees inward while running are particularly prone to IT Band Syndrome. The rotation is thought to increase strain on the IT band, causing it to rub uncomfortably against a part of the femur bone located on the outside of the knee.

Several factors can cause these irritating movements, says Gordon, including fatigue, tight muscles, running on uneven terrain, like on a sloped side of a road, or frequently changing direction while running. An athlete’s natural gait may also be flawed—two of the most common issues come from runners who either rotate their knees inward or sway their hips from side with each stride. On the bike, improper cleat position can be a culprit.

“Always get in a good warm up,” Gordon says. Loosening up the IT band and the muscles that surround it will help keep it from pulling tightly against the upper femur bone. For runners, a warm-up should include a five to 10 minute jog, with some plyometric moves like high knees and skipping thrown in to get the hips moving. Switching up your running terrain can also help because running every day on the same road, with the same slant, can also strain the IT band. Intervals on the track should be run in the third lane because the larger curve puts less stress on the inner leg’s IT band. Running tight curves on the track can aggravate the inner leg’s IT band because it must work harder to keep the leg from swinging toward the outside of the curve, according to The Maryland  Sports Injury Center.

The jury’s out on whether strengthening the hips helps, but stretching is always advised, as a tight IT band is more likely rub against that femur bone, causing pain. Try these two stretches from the Nicholas Institute of Sports Medicine and Athletic Trauma:

1. Standing IT Band Stretch
Start standing upright. Then cross the right leg over the left, and lean to the right, bending at your hip. This will stretch the left IT band. Repeat on the other side. The first stretch in this video shows this technique:

2. On the Ground IT Band Stretch

Lying on your back, lift your right leg over your left leg, keeping your back flat on the ground, and hold it there by placing your left hand on your right knee. Your body should look like an upside down 4, with your right thigh as the horizontal line. Repeat on opposite side. The second stretch in this video illustrates this technique:


Filed To: Injury Prevention