Common Running Injuries – Iliotibial Band Syndrome (ITBS)

Iliotibial Band Syndrome (ITBS) is a common overuse injury in which symptoms are felt on the lateral part of your knee, especially during repetitive physical activity. Your IT band is a thick piece of connective tissue formed by 2 muscles in your hip (your glute max and tensor fasciae latae) that travels down the outside of your thigh and attaches just below your knee. ITBS is an overuse syndrome in which excessive tension in your IT band causes your IT band to rub against your femur, which causes discomfort and pain. If you’re experiencing pain in that area that worsens with activity, as well as other symptoms, like snapping or cracking in that area, you may be experiencing ITBS.

There are several steps you can take to resolve ITBS. The first step is activity modification. If you are doing a repetitive physical activity, such as running, you may want to reduce your mileage or frequency. Being a runner myself, I know it can be tough to modify your regimen, especially if you’re training for a race, but it may be a good idea to adjust your running program at least until your symptoms calm down. You also want to take a look at your running route. If you run on the same side of the street, try to switch it up so that one leg isn’t on the crown of the road the entire time, which can put excessive tension on your IT band too. Hip strengthening is also a very important component in resolving ITBS. People with ITBS are found to have hip musculature weakness that causes your knee to cave in into valgus (see picture below). This position predisposes you to injury and it also puts tension on that IT band. For strengthening exercises, check out our videos for lower extremity strengthening and pay attention to exercises like side steps, side-lying hip abduction, clamshells, and stepdowns.

Stretching and foam rolling have also been found to relieve symptoms of ITBS. Like I mentioned earlier, your IT band is very thick so it’s unlikely you’re lengthening it with these stretches or techniques. However, these methods do help desensitize the area so that when you go to run or do physical activity, you feel less pain. If you’re feeling pain on the outside of your knee, try massaging the area with a roller stick, foam roller, tennis ball, or even a rolling pin! You can also give these IT band stretches (see video below)! Make sure when you do them, you hold for 15-20s and perform 4-5 reps. Make sure you feel a stretch in your outer thigh. These techniques are great to do before going out for your run!

As always, contact your favorite 3D physical therapist with any questions. Happy Running, everyone!