IT Band Knee Pain: Symptoms & Treatment Explained


If you’re an athlete or avid runner, you’re probably no stranger to occasional knee pain. But what about when that pain is on your outer thigh or outside your knee?

This type of pain is often the result of inflammation or irritation in the iliotibial band. This ligament runs along the outside of your thigh and can be quite painful and may affect your ability to train or compete. The good news is that a physical therapist can help you manage your symptoms and get you back to your sport.

In this post, we’ll explain what iliotibial band syndrome is, how to recognize the symptoms, and how to fix it. Let’s get started!


What is iliotibial band syndrome?

Iliotibial band syndrome is a condition that results from inflammation or irritation of the iliotibial band. The condition is a common injury among long-distance runners. It often affects runners who increase their mileage too quickly or have improper running form. Still, iliotibial band syndrome can also occur in other athletes who put repetitive stress on their knees, such as cyclists, soccer players, football players, and tennis players. Iliotibial band syndrome can also be caused by muscle imbalances, such as weak hip muscles or tight calf muscles.

What is the iliotibial band?

The iliotibial band is a thick band of connective tissue that attaches at your hip and runs down the length of your thigh, ending just below your knee. It’s responsible for stabilizing the knee joint and helping the leg muscles move in a coordinated fashion. It also helps to support your body weight when you walk, run, or jump, and helps to absorb shock as you run or walk.

When this ligament becomes inflamed or irritated, it can cause sharp, burning pain on the outside of your knee, especially when you bend your knee or walk up and down stairs.

Why does iliotibial band syndrome happen?

Iliotibial band syndrome can happen for several reasons, including;

Overuse injury:

Repeatedly bending the knee can irritate the IT band and lead to inflammation.

Poor biomechanics:

If your feet roll inward when you walk or run (a condition known as overpronation), it can stress the IT band and cause pain.

Muscle imbalances:

Weakness in the hip muscles or tightness in the muscles along the IT band can lead to ITBS.


A direct blow to the knee can cause the IT band to become inflamed or irritated.

Improper form:

If you don’t use proper form when exercising, it can put extra stress on the IT band and lead to pain.

Misalignment in the hips or knees:

If your hips or knees are out of alignment, it can lead to IT band syndrome.

Weak glutes:

Weak glutes can cause your pelvis to rotate and put extra strain on the IT band.

Tight hamstrings:

Tight hamstrings can also cause your pelvis to rotate and lead to IT band syndrome.

What does IT band syndrome feel like?

Iliotibial band syndrome is often described as a sharp, burning pain on the outside of the knee. This pain is usually dull and achy at first but can become intense and severe with continued activity. The pain may come and go at first but can become more constant as the condition progresses.

In short, here is how IT band syndrome feels like:

  • Pain on the outside of your knee which may be burning or sharp

  • Pain that worsens when you bend your knee, walk up or down stairs, or stand for long periods of time

  • Stiffness and difficulty moving your knee

  • Swelling, tenderness or warmth around the affected area

  • Clicking or popping sounds when you move your knee

  • A dull ache after prolonged sitting or standing

  • Hip abductor weakness.

Iliotibial band syndrome is usually worse:

  • When walking up or down stairs

  • After long periods of sitting with your legs bent, such as in a car

  • When you exercise, especially if you don’t warm up properly first

  • When it’s cold outside.

Iliotibial band syndrome may worsen as your run progresses and eventually causes you to stop running altogether.

If you’re experiencing any of these symptoms, it’s important to see a doctor or physical therapist to get a proper diagnosis. They will be able to rule out other conditions that may be causing your pain, such as arthritis, bursitis, or patellofemoral pain syndrome.

How is iliotibial band syndrome diagnosed?

IT band syndrome is usually diagnosed based on your symptoms and a physical examination. Your doctor will ask about your medical history and how long you’ve been experiencing pain. They will also perform a physical examination, during which they will check for tenderness or swelling around the outside of your knee. They may also order X-rays or an MRI to rule out other conditions causing your pain, including patellofemoral pain syndrome (PFPS) or meniscus tear.

Tests done to diagnose iliotibial band syndrome

The test may include:

  • Checking for tenderness or swelling around the outside of your knee

  • Checking your range of motion

  • Checking for muscle weakness or imbalances

  • Performing an X-ray for chronic inflammation or MRI to rule out other conditions.

If you have pain, it’s important to listen to your body. You might need to see a physical therapist to help fix the pain.

How is iliotibial band syndrome treated?

Once they have diagnosed you, a physical therapist may suggest or create different types of treatments plans, including the following.

Exercise Interventions:

  • This includes sports physical therapy exercises that stretch and strengthen the muscles around the hip and knee, such as the iliotibial band, quadriceps, and hamstrings.
  • Foam rolling to help relieve muscle tension and improve flexibility.

Massage therapy:

  • Massaging the muscles and soft tissues around the knee can help release tight muscles and improve the range of motion.

Ice and heat therapy:

  • Applying ice or heat to the affected area for 15-20 minutes can help reduce pain and swelling.


  • Ultrasound therapy uses sound waves to promote healing and reduce pain.

Electrical stimulation:

  • This therapy uses electrical currents to reduce pain and inflammation.

Taping or bracing:

  • Wearing a supportive tape or brace can help stabilize the knee and reduce lateral knee pain.

Surgery (iliotibial band release):

  • This type of surgery involves cutting or releasing the ligament to relieve pressure on the knee or remove a portion of the IT band. It should be reserved for severe cases that haven’t responded to other treatments.


  • Rest is probably the most important thing you can do to treat iliotibial band syndrome. Avoid activities that make your pain worse, and give your body time to heal.

How long does it take an IT band to heal?

With proper treatment, iliotibial band syndrome is usually resolved within several weeks. Most people start to feel better within 4 to 6 weeks, but it might take longer.

If you don’t treat the pain, it might worsen and turn into another type of pain called patellofemoral pain syndrome. It is important to see a doctor or physical therapist to create a rehabilitation program/treatment plan.

How can I avoid getting IT band syndrome again?

Preventing iliotibial band syndrome for long-distance runners, cyclists, and football players may be difficult. However, you can help prevent iliotibial band syndrome by doing the following:

  • Start your workout session with a 5-10 minutes warm-up that includes light aerobic activity and dynamic stretching exercises like leg swings or high knees. You can also do strength training exercises like squats, lunges, or step-ups.

  • Avoid high-impact exercises such as running on concrete or asphalt surfaces. Instead try to run on soft surfaces, such as grass or a treadmill, as much as possible. If you must run on these surfaces, be sure to wear shoes with good shock absorption qualities. This will minimize the risks of developing symptoms of iliotibial band syndrome.

  • Incorporate cross-training activities into your workout routine. Swimming and biking are excellent choices because they place little stress on the knees.

  • Gradually increase the intensity and duration of your workout sessions. Avoid sudden increases, which can place undue stress on the iliotibial band and lead to injury.

  • Wear shoes that fit properly and provide adequate support. Replace your shoes every 350 to 500 miles to ensure they continue to provide proper support.

  • Stretch the muscles around the iliotibial band before and after exercise sessions. Hold each stretch for 30 seconds.

  • Massage the muscles around the iliotibial band with a foam roller or tennis ball. Roll back and forth over the muscle for two minutes. Repeat two or three times per day.

  • Apply ice to the iliotibial band for 20 minutes after exercise sessions or when you experience pain.

  • Try wearing a knee brace during exercise sessions. The braces can help to provide support and stability to the knee joint.

  • Strengthen the iliotibial band muscles by doing exercises such as

    • Yoga

    • Pilates

    • Cycling

    • Swimming

If you’re feeling pain, it’s critical to pay attention to your body. It’s also possible that you’ll need physical therapy to help fix the problem.

Iliotibial band syndrome exercises

Here are some exercises that can help stretch and strengthen the iliotibial band muscles.

1. Hamstring stretch: Lie on your back with one leg straight and the other bent at the knee. Use a strap or towel around your foot to keep your leg in place. Slowly straighten your leg until you feel a stretch in the back of your thigh. Hold for 30 seconds and repeat three times on each leg.

2. IT band stretch: Lie on your side with your affected leg on top. Bend your knee and grab your ankle with your hand. Gently pull your leg towards your chest until you feel a stretch along the outside of your thigh. Hold for 30 seconds and repeat three times on each leg.

3. Gluteal stretch: Lie on your back with your knees bent and feet flat on the ground. Cross one leg over the other and grab your ankle with your hand. Gently pull your leg towards your chest until you feel a stretch in your glutes. Hold for 30 seconds and repeat three times on each leg.

4. Quadriceps stretch: Stand up tall and hold on to a chair or wall for balance. Bend one knee and grab your ankle with your hand. Gently pull your leg towards your buttock until you feel a stretch in the front of your thigh. Hold for 30 seconds and repeat three times on each leg.

5. Standing IT band stretch: Stand up tall and hold onto a chair or wall for balance. Cross one leg in front of the other and bend your knees. Slowly lean to the side until you feel a stretch along the outside of your thigh. Hold for 30 seconds and repeat three times on each leg.

What exercises should be avoided with iliotibial band IT band syndrome?

Avoid the following exercises if you have iliotibial band syndrome.

1. Cycling: Riding a bicycle can aggravate iliotibial band syndrome because it places stress on the knee joint.

2. Running: Running can also aggravate iliotibial band syndrome because it puts repetitive stress on the knee joint.

3. Jumping: Any jumping exercise, such as jump squats or box jumps, should be avoided because it can stress the knee joint.

4. Exercises that place a lot of stress on the knees: Activities such as deep squatting, lunging, and stair climbing can aggravate the iliotibial band and make you feel pain. If you have ITB syndrome, it’s important to avoid these exercises.

5. Weightlifting and any other activity with increased knee flexion: Exercises like leg curls and leg extensions should be avoided. They can place stress on the knee joint and aggravate iliotibial band syndrome.

Bottom line

If you are experiencing pain outside of your knee that worsens with activity, tenderness to the touch, swelling, and/or stiffness, it may be iliotibial band syndrome.

This condition is common in long-distance runners. It can also occur in people who do other activities that require repetitive knee movement.

Treatment typically involves rest, ice, and physical therapy. In some cases, orthopedic surgery may be necessary.

If you are having trouble managing your pain, we can help. Our team at Fit Club NY can help you overcome your IT band knee pain and get you back to your favorite activities.

Contact us today to schedule an appointment.

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