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April 9, 2012 Comments (8) Training

IT Band Syndrome – A Runners Worst Nightmare

Mark Kreuzer Rolling his IT Band

My first experience with IT Band Syndrome,  ITBS, ITB or just IT as I like to call it, came 9 years ago.  I started training with more miles on the roads and one day I’m stabbed in the side of the knee with an Ice Pick. Well, that’s how it felt.  I really thought I’d broken something or done some type of serious damage… IT hurts that bad.

For those who have never had it be thankful.  For those who have it… those who haven’t will never understand the pain… you know what I mean.

The IT Iliotibial muscle band originates up around your glutes, continues down your leg, runs past the outside of your knee and terminates below the knee.  If this band gets tight or inflamed then the most common symptom becomes this horrendous pain on the outside of your knee.

I made a failed attempt at recovery by seeing an Ortho Doc who prescribed pills and RICE.  6 weeks of that did squat to help the issue.  One day at the gym I saw someone rolling the side of their leg on foam roller and talking about IT.  BAM!!!  In one week I was back to running full time.  FIXED !

Since that time, I’ve had little bouts with ITBS.  With lots of experimenting and research I’ve gotten well very quickly  and have helped a good number of runners I coached as well.  Here’s what I’ve learned:

  1. The point where it hurts is not the point of origin for ITBS.  The pain on the outside of the knee is the symptom of a tight or inflamed IT Band.
  2. I personally don’t consider ITBS an injury although you will swear you are broken.
  3. The IT muscle Band is not the only player in the game.  The glutes, hip flexors, hamstrings and piriformis have a lot to do with it also.  If they are tight, or injured, then the IT can become aggravated or tight as well.
  4. RICE is not the answer.  Never found any of that to work with the exception of a strap around the top of my knee, as compression during a race and just so I could keep moving forward.  Taking time off will help the inflammation around the knee but will not fix the underlying problem.
  5. Active Recovery is the answer.  Stretching and rolling your IT Band, Glutes, Hamstrings, Piriformis and Hip Flexors.   In many cases, stretching and rolling will make the ITB disappear in a week.
  6. In a continuation of #4… Strengthening your hamstrings, glutes and hip flexors is very important.  Sounds counter intuitive right?  I’ve learned that a weak muscle often becomes a tight muscle must faster because it fatigues faster.   In my last bout of IT all the stretching in the world did not help.  I hit the gym, strengthening those areas, and it disappeared in less than 2 weeks.
  7. When ITBS strikes for the fist time you will think you’ve broken something.  I’ve had some runners swear they were seriously injured and went to get MRI’s.  It’s always been IT.  If you think you’re injured by all means get looked at but if the pain subsides after exercise then it’s generally ITBS.  I am not a doctor and this is not medical advice.  Any medical professional would tell you to have it checked out… so I will say the same.
  8. The foam roller is your friend… a very uncomfortable painful friend.  Learn how to use one.
  9. Medication.  I’m not a big fan.  I don’t like masking pain.  Pain tells me something is up and I like to listen to it in order to locate and work towards fixing the issue.
  10. Personally, ITB strikes when I’m on the roads.  It’s not the roads themselves as much as the repetitiveness of the running.
Hope this helps a little.  Try to remain calm when it happens.  Read, research and implement a recovery plan and you’ll be back to running faster than you think.




8 Responses to IT Band Syndrome – A Runners Worst Nightmare

  1. Joy Geltmacher says:

    Great advice! I have been having some it issues since I do a lot of road racing. I love my foam roller and find deep tissue massage helpful as well. As much as I dislike it, I know weights help to keep me strong and pain free.

  2. Andrew Hostetler says:

    Could you describe some of the strengthening exercises you used when you were injured? I’ve been dealing with this for the past 2 months now and it’s getting kind of frustrating. It’s a relief to know that it’s so easy to fix!

    • mkreuzer says:

      Andrew, I did deep lunges and squats. I also did hamstring curls on a machine and those inner and outer thigh machines. You can use a thera-band, tie it in a circle, insert both feet then and step to the side with one leg. Bring the other foot back to the first and step again to the side over and over. Switch directions and repeat. Once my glutes, hamstrings and inner/outer thighs get strong the IT pain goes away.

      • Andrew Hostetler says:

        Thanks very much for the suggestions. I tend to stay away from machines in the gym, but I will use a theraband like you described. You’re a life saver!

  3. Michelle says:

    I know this is an old post but hopefully it will still get to you. What do you do to keep cardio in your routine since you couldn’t run?

    • mkreuzer says:

      Hey Michelle, a lot of times if you can strengthen and stretch the muscles that cause the ITB it will go away very quickly. Many people rest for long periods of time to get rid of ITB but that generally does nothing to fix the root cause. I know that’s not exactly an answer to the cardio question but I think you can get rid of it quickly and not have to worry about alternative cardio.

  4. Kristen says:

    I totally agree with your advice and it has worked for me. The foam roller helped and stretching. It is interesting to note that I have been running primarily road lately and ITB is acting up. NOTE TO SELF: get back on the trail.


    6 years on, it is still this solution works. I really had bad pain on both knees following a hill race over the weekend. I thought I was strong at legs as I was doing strengthening. It appears that I need to do more strengthening around core, quads, hamstring and foam rolling.

    This pain really hurts, don’t be surprised if a drop of water falls from your eyes – it is that sharp pain !!

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