ITB Injury From Running

A common injury that is due to overuse or "doing too much" is the Iliotbial Band Syndrome, commonly referred to as an ITB injury. The ITB is a thick muscle that extends from the hip to the outside of the knee. This muscle helps to stabilize the knee and to rotate the foot during heel/foot strike and toe-off. The ITB rubs against a bone that is just above the knee and can become inflamed.
IT Band injuries can have several causes, including the following.
  • Increasing mileage too quickly
  • Running too fast for the current body condition
  • Running on roads with a curvature or crown such that the same leg is always on the outside of the road
  • Insufficient stretching of the IT Band and hip-related muscles
  • Excessive pronation and not wearing proper shoes
Treatment does not involve surgery. It does involve physical therapy, flexibility and strengthening stretches for the hip and knees, getting proper shoes or orthotics, rest from running, and a slow, gradual return to running.
CAUTION: Do not try to run through the pain of an ITB injury!! You may make the injury worse, and it could become chronic. Here is a great article on ITB injuries.

The information on this site is for informational purposes only; it does not constitute medical or physical therapy advice. For medical advice, consult a physician. For physical therapy advice, consult a physical therapist.


scottatl said...


Appreciate the site and had a question. Tweaked my IT band over the holiday and have taken up swimming, low-impact elliptical/stationary bike and jump rope in the meantime. I have also purchased a foam roller to help stretch the area in question. My question is how long til I should hit the road again. I was running about 35 miles a week, does this mean I need to do .5 or 1 mile at a time when i do start running again?



Allen said...

Hi Scott,

I can't give an exact answer to your question since we're all different. A general answer is to listen to your body and to make increases in distance or speed appropriately.

I've found that when I'm off running for a relatively long time for some reason, I can usually start back in doing about half the distance I was doing before.

One "parameter" that I've found useful for me is my body energy. Whenever I feel tired, I take an extra rest day or two (until I feel energetic again). Of course, my age (73) is a key factor in how fast I get back into running. Doing the low-impact cross training that you mentioned is a good alternate to taking a full day of rest. At my advanced age, I need the full day of rest.

Anonymous said...

Hi Allen, My husband and I have really appreciated this site as we are training for our first 1/2 marathon. We are very excited and things were going well until I hit a 6 miler last Saturday. I already have a right knee injury (Not IT) and thought that it may be my barrier, but turns out I have tweaked my left IT. I am sure it may be for lots of reasons, especially some compensation. I see the comments on REST, but what do you suggest for someone that hopes to complete a 1/2 marathon on April 25th. Thanks

Allen said...

Hi Anon,

I'm sorry to hear about your knee injury. If it were me I would take 2-3 days of rest and then ease back into my running. If you're not already doing them, do exercises for ITB, hips, and knees. The exercises that I do are illustrated in my page of pictures of stretch exercises.

How are your shoes? Maybe it is time for a new pair? Runners usually get 400-500 miles on shoes. Do you have the the right kind of shoes? There are three kinds of shoes, neutral, support, and motion control. My shoe pages gives some general info. If you do buy new shoes, go to a good running store where the clerk will watch you walk and even better run on a tread mill. The ITB is involved with rotation of your foot as you walk/run, and the three kinds of shoes are designed to control that motion.

Maybe you need to back off in your training and make smaller increases in distance or less often increases to give your body more time to adjust to the distance.

Be sure you change direction on loops or run the same physical side of out-back so both legs share being on the outside of the street.

You hope to run your half marathon in April, but be sure you get healed first. If you miss the April race, that's OK. Pick another race later in the year; life will go on for you. I was hoping to run a half marathon at the Utah Senior Games in October, but I came down with blood clots. I haven't run for two months, and I hope to start jogging next week. So, I'm planning on the half in 2010.

Allen said...

One more comment, Anon. Use Google to find other stretches for ITB, hips, and knees, as well as choosing shoes, and ITB general info. Use two or three keywords in your searches, such as running itb stretch.

Anonymous said...

Thank you for your helpful advice. I will make sure to check out the stretches and the shoes. I am bummed about the injury, but it is nice to read your encouraging words as life does go on. Good luck to you in meeting your goal in 2010. Best of Health to you.

Allen said...

I've never used one, but here is an article from the Guide at about using a rolling stick on IT bands.

Nathan said...

While training for my physical test for the National Guard, I began feeling ITBS-like symptoms in my left knee.
Unfortunately, because I'm new to running long distances, I didn't know what this was and continued training.
In fact, I'm so stubborn that I would complete my run even though I was experiencing pain in my left knee and, at the time, in my left achilles tendon.
Since then, I have researched the injury, purchased new shoes and incorporated various stretches, strengthening exercises and icing into my rehabilitation.
It has only been one week since the injury occured, but I will most likely rest for another week to play it safe.
Also, after reading through your website and description and causes of ITBS, I remembered that the route I ran, being the same, kept my left leg on the outside, nearest the road. I'm assuming my ITBS, though most likely caused by numerous factors, may also have been attributed to the fact that I, basically, ran a large circle around a lake and always in the same direction.
I think I will stick to treadmills for a while. They have yet to hurt me.
Thank you for the help.