IT Band Syndrome: What It Is, What To Do
Be on the alert for Iliotibial Band Syndrome, one of the most common running injuries.

IT Band Syndrome: What It Is, What to Do

Iliotibial Band Syndrome (ITBS) is one of the more common injuries among runners. The IT band is like a seam in your pants. This thick, dense, connective tissue or fascia, extends from the outside of your hip to down just past your knee joint.

The IT band, the longest tendon of your body, attaches to you knee and helps stabilize the joint, but when you are not moving properly it can become inflamed. The IT band passes over a bony prominence just above the knee joint, and too much “friction” can lead to irritation. It also attaches to a very short muscle, which is just there to take up the slack when you move.

People often confuse ITBS with a knee joint injury. To help differentiate, feel for a little bump on the end of your thigh bone, just up from the outside of your knee joint. As you bend your knee back and forth past 30 degrees, you will likely reproduce your ITBS symptoms.

What Causes IT Band Syndrome?

ITBS is most commonly an overuse issue and often related to poor running form and/or simply running too much. Other contributing factors may be running in the same direction on a cambered road or trail or poor stability of your hip or ankle joints, causing the knee to be caught in the middle dealing with the stresses. Adding core and hip strengthening exercises to your regimen and refreshing your running and non-running footwear may help mitigate your symptoms.

What to Do If You Develop IT Band Syndrome?

Many doctors will tell you to stop running if you develop ITBS. Unfortunately, you can easily become deconditioned and exacerbate the problem when you return to running. So, I say take active rest, while maintaining your strength and aerobic fitness.

I recommend cross training with another aerobic sport, such as swimming, riding the elliptical trainer, or cycling, and possibly adding some weight and core training to enhance your balance when your feet hit the ground again.

Should I Stretch?

As the IT band is thick and dense, stretching it may have little effect. You may find more benefit in stretching adjacent tissues such as your quadriceps, hamstrings, and hip abductor and adductor muscles. Doing this may “stretch” connecting fascia and decrease tension on the IT band. I don’t go into a rigorous stretching routine before I start my run, but I make sure I get a good warmup.

The best warmup for your sport is actually doing the sport itself, possibly at a slower pace or less vigorously. A baseball player would take a few swings in the on-deck circle before walking up to the plate, a tennis player would hit a few balls before the match, and a seasoned runner would do some running at different speeds before the sound of the starting gun. For any run, start off a little slower and see if you can build your speed to maintain or exceed your starting pace.

Brian Soo, Physical Therapist

Brian Soo, Physical Therapist

Brian Soo is a senior physical therapist at the Kaiser Permanente San Francisco Medical Center who works inpatient, outpatient, and in sports medicine.  A recreational runner for many years, Brian also bicycles, plays racquetball, and most importantly, paddles on a 20-person Dragon Boat team that competes internationally and practices three times a week. He also enjoys active video games and believes they can be an excellent complement to an overall fitness regime.