If you’ve ever felt pain right outside your knee, you may have assumed that you have a knee injury. But it’s also possible that you have a tight IT band.
So what is an IT band? “The iliotibial (IT) band is a dense band of fibrous connective tissue which runs from the outside of the pelvis and runs over the outside of the hip and the outer thigh, extending to just below the outer aspect of the knee,” says Edward Laskowski, M.D., co-director and specialist in physical medicine and rehabilitation at Mayo Clinic Sports Medicine.
It helps stabilize your upper legs and integrates them with the lumbar spine, hip, femur (thigh bone), and knee function.
“The function of the IT Band is to aid in the assistance of the hip into flexion, external rotation and abduction while providing stability and control of the hip-knee relationship with global movement,” says John Rusin, DPT, PT, CSCS a strength coach and physical therapist based in Madison, WI.
Why does your IT band hurt?
If you have pain in your IT band, trust us: you know.
“The pain is worse with impact-loading, such as when the foot hits the ground during runs, and can feel like a burning sensation. The pain can be surprisingly sharp and persistent,” says Laskowski.
There are a few different potential causes. “IT band pain occurs when the part of the band near the outside of the knee creates friction with the outer aspect of the femur [thigh bone] near the knee and causes inflammation,” says Laskowski. The rubbing of the band over your bony bump, combined with repeated flexing and extending of the knee, causes pain on the outer aspect of the knee.
Running is often the cause of IT band pain. “Running on banked surfaces (and running only on one side of the road), running downhill, and especially longer distance runs, can all contribute to IT band pain,” says Laskowski.
But it’s not just running that can cause the pain.
“From my clinical experience, I’ve seen regional ‘IT band pain’ stem from poor movement patterns, lack of functional hip mobility and control, a lack of ankle mobility, and common overuse injuries with low amplitude high repetition based movements,” says Rusin. Basically, if you have bad form, that increases the risk of IT band pain.
How to treat IT band pain
You can start with good stretching.
Try this stretch, which is the best for IT band stretching, according to Dr. Laskowski.
Stand near a wall or a piece of sturdy exercise equipment for support. Cross your left leg over your right leg at the ankle. Extend your left arm overhead, reaching toward your right side. You’ll feel a stretch along your left hip. Hold for about 30 seconds. Switch sides and repeat.
“In addition to stretching, a foam roller can be helpful to massage the IT band, increase blood flow and provide some element of loosening to the tissue,” says Laskowski.
But stretching isn’t the most important thing. It’s all about strength-training for your hip muscles to help stabilize the leg and prevent inward rotation of the knee.
Laskowski suggests doing hip abduction walks with resistance tubing to work the hip muscles. The hip abduction walk targets the hip abductor muscles on the outside of the hips. This exercise trains the hip abductors to work as stabilizers, which is how they’re used in daily life. Keep your knees slightly bent during the exercise, keeping your steps smooth and controlled as you feel the tension along your outside leg and hip. Move lateral side to side until your form begins to fail. The switch to frontward and backward steps.
“Strength training should be performed 2 to 3 days per week; keep an off day between working the same muscle groups. You should start to see some gradual improvement over a period of 4 to 6 weeks,” says Dr. Laskowski.
If you want to prevent IT band pain, also avoid rapid increases in running mileage. Try to increase no more than 10 percent of your running mileage per week, says Dr. Laskowski.