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IT Band Syndrome: Causes, Risk Factors, and Treatment Options

June 14th, 2024 | 5 min. read

IT Band Syndrome: Causes, Risk Factors, and Treatment Options
Elise Barron

Elise Barron

Licensed Physical Therapist, PT, DPT // EW Motion Therapy Homewood

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IT Band Syndrome, also known as Iliotibial Band Syndrome, is a common injury that affects many athletes, especially runners. It is characterized by pain and inflammation on the outer part of the knee and/or hip, which can significantly hinder performance and daily activities. Physical therapy is often an integral part of any treatment plan for IT Band Syndrome - our team at EW Motion Therapy loves helping our clients with IT Band Syndrome to reduce pain and return to the activities they love. You may decide that our physical therapy doesn’t fit your needs, but understanding the causes, risk factors, and treatment options for IT Band Syndrome is crucial for prevention and effective management.


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What causes IT Band Syndrome?

The Iliotibial (IT) band is a thick band of fascia that runs from the hip to the knee. IT Band Syndrome occurs when this band becomes tight or inflamed, causing pain, irritation, and a clicking or popping sensation on the outside of the knee. Several factors contribute to the development of this condition:


  1. Overuse: Repetitive activities, especially those involving knee movement, can cause the IT band to become tight and irritated. This is why IT Band Syndrome is prevalent among runners, particularly distance runners. 
  2. Biomechanical issues: Poor running form, flat feet, or conditions like genu varum can lead to uneven stress on the IT band, contributing to inflammation. 
  3. Weak hip muscles: Weakness in the hip muscles, particularly the abductors, can cause instability and increased stress on the IT band.
  4. Improper footwear: Wearing shoes that do not provide adequate support can alter running mechanics, increasing the risk of developing IT Band Syndrome.
  5. Age and gender: Due to anatomical and hormonal differences, younger athletes and females are at a higher risk of developing IT Band Syndrome.


Why is IT Band Syndrome common in runners?

Running involves repetitive knee flexion and extension, significantly stressing the IT band. As runners increase their mileage or intensity, the repetitive friction between the IT band and the lateral femoral epicondyle (the outer part of the knee) can lead to inflammation and pain. Several factors contribute to the prevalence of IT Band Syndrome among runners:


  1. Training errors: Sudden increases in running distance or intensity without proper conditioning can overload the IT band.
  2. Surface and terrain: Running on uneven or sloped surfaces can cause uneven stress distribution, exacerbating IT band issues.
  3. Running form: Poor running mechanics, such as excessive inward knee movement or overstriding, can increase the likelihood of developing IT Band Syndrome.
  4. Inadequate recovery: Insufficient rest and recovery between runs can prevent the IT band from healing properly, leading to chronic inflammation. Proper warm-up and cool-down in your routine, as well as rest days, are essential to prevent overtraining.


Treatment options for IT Band Syndrome

Effective treatment for IT Band Syndrome involves a combination of rest, physical therapy, and lifestyle modifications. The primary goals are to reduce inflammation, alleviate pain, and address the underlying causes to prevent recurrence.


  1. Rest and activity modification: Reducing or temporarily stopping activities that aggravate the IT band is essential for allowing the inflammation to subside.
  2. Ice and anti-inflammatory medications: Applying ice to the affected area, taking nonsteroidal anti-inflammatory drugs (NSAIDs), and steroid injections can help reduce pain and inflammation.
  3. Stretching and foam rolling: Stretching the IT band and hip muscles and foam rolling can alleviate tightness and improve flexibility.
  4. Orthotics and footwear: Custom orthotics or proper running shoes can address biomechanical issues and provide adequate support.


How physical therapy can help IT Band Syndrome

Physical therapy is crucial in the comprehensive management of IT Band Syndrome. A skilled physical therapist can identify the root causes of the condition and develop a tailored treatment plan to address them. Here’s how physical therapy can help:


  1. Assessment and diagnosis: Your therapist will thoroughly assess biomechanical issues, muscle imbalances, and movement patterns contributing to IT Band Syndrome. This can include a gait analysis and other mobility tests.
  2. Manual therapy: Hands-on techniques to release tight muscles, improve tissue mobility, and reduce pain.
  3. Customized exercise programs: Targeted exercises can strengthen the hip, gluteal, and core muscles and improve range of motion, reducing stress on the IT band.
  4. Education and guidance: Providing education on proper running mechanics, training modifications, and injury prevention strategies.
  5. Progressive rehabilitation: Gradual progression of exercises and activities will ensure a safe return to regular activity and prevent re-injury.


IT Band Syndrome is a common but manageable condition that affects many athletes, particularly runners. Understanding the causes, risk factors, and treatment options is essential for effective management and prevention. By addressing the underlying issues through rest, strengthening exercises, and physical therapy, you can recover from IT Band Syndrome and return to your favorite activities pain-free. If you are experiencing symptoms of IT Band Syndrome, consulting with a physical therapist can provide the personalized care and guidance needed to achieve optimal recovery. We have many runners on our team at EW Motion Therapy, and they can help you return to the activities you love. To learn more about what your physical therapy treatment might cost, click the button below to download our free pricing guide.


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