Understanding and Treating Iliotibial (IT) Band Syndrome

Everything You Need to Know About the Iliotibial (IT) Band and IT Band Syndrome

What is the IT Band?

The IT band is a thick band of connective tissue that runs down the outside of the thigh starting
from the hip and attaching just below the outside of the knee. At the hip, it connects with two
muscles: tensor fascia latae (TFL) and gluteus maximus. The purpose of the IT band is to
provide stability for the knee and assist in the store and release of forces through the lower

What is IT band syndrome?

IT band syndrome is a condition that is characterized by pain located on the outside of the knee.
It often occurs with activities that involve repetitive knee flexion, extension and pivoting. IT band
syndrome is a common running injury and can be related to errors in training load. Increasing
parameters such as frequency, intensity or speed too quickly may increase the risk of
developing IT band syndrome. Other risk factors may include poor flexibility or weakness in the
surrounding musculature of the hip and knee.

How do I treat IT band syndrome?

For the management of IT band syndrome, the first line of treatment is commonly physiotherapy.
In the early stages of rehab, the main goals are to decrease pain and minimize actions that are
most aggravating for your symptoms. This may include manual therapy, exercises and taping.
Activity modification also plays an important role in successful management of IT band
syndrome in the early stages. Decreasing the aggravating activities will allow your body time to
rest. A physiotherapist may suggest to scale back your running or perform alternative activities
that do not increase your symptoms such as walking or swimming.

As symptoms begin to decrease and you transition to the middle and later stages of rehab, the
goals change to targeting the reasons for the injury occurring in the first place. As stated earlier,
IT band syndrome can occur due to tightness or weakness in muscles surrounding the hip and
knee joint. Your physiotherapist may suggest working on strengthening exercises that target
these areas and prepare you to return to your normal physical activities. They will also advise
you on how to safely and gradually progress back to the activities you enjoy.
For a few exercises to get started, check out our video on IT band syndrome on our instagram

Should I foam roll my IT band?

You may have heard or read that you should stretch or foam roll your IT band to improve
mobility. However, if we think back to the anatomy of the IT band, it is not a muscle, which
means it does not stretch in the same way our muscles are able to. Instead, it can be helpful to
foam roll the muscles that connect to the IT band (TFL and gluteus maximus). A physiotherapist
will be able to identify if this is an appropriate technique to manage your IT band symptoms.

Return to Running After IT Band Syndrome

Since IT band syndrome in runners is often related to training errors, it is important to consider
these factors when progressing back into running. Some research suggests incline running or
increasing cadence to decrease stride length can be helpful to manage knee pain when running.
It is also important to gradually return to your previous running level. Returning too fast could
reaggravate the symptoms. This may mean starting with a walk run program (ex. Run for 1 min,
then walk for 1 min, 5-10 times). Allowing your body time to adjust to higher intensity activities
will help prevent recurrence or other lower extremity injuries. If you would like to know more
about returning to running after IT band syndrome, consult your physiotherapist.