What Is IT Band Syndrome?

Iliotibial band syndrome is a condition that often affects runners and cyclists

The iliotibial (IT) band is a strong band of tissue that starts at the hip and runs along the outer thigh. It attaches on the outside of the shin bone, or tibia, just below the knee joint. The band works with your thigh muscles to provide stability to the outside of the knee during movement.

IT band syndrome occurs from irritation or an injury, often in athletes (like long-distance runners) or from certain exercises and workout practices. It can also result from faulty biomechanics, which is when parts of your body are not properly aligned. There are both at-home and prescription treatments available for this condition.

This article will explain the symptoms and causes of IT band syndrome. It will also help you to learn the options for IT band treatment and when to see your healthcare provider for a diagnosis.

Causes of IT Band Syndrome.

Verywell / Alexandra Gordon

Symptoms of IT Band Syndrome

IT band syndrome is most commonly seen in runners, but it can also impact cyclists, competitive rowers, those who play sports like soccer or basketball, and those who are new to working out.

The symptoms of a tight IT band may include:

  • Knee pain on the outside of the knee that may burn
  • Thigh and hip pain that may ache and burn
  • Pain while exercising
  • Pain that continues after you stop working out

Over time, the IT band pain may become constant and sharp. As the pain becomes more severe, swelling on the outside of the knee may occur.

What Causes IT Band Syndrome?

IT band syndrome may occur if the IT band gets irritated from rubbing up against bone while it is stretched. It can also occur if the hip or knee bursa, which is a fluid-filled sac that helps with movement, becomes swollen. Causes may include:

  • Wearing non-supportive shoes
  • Running downhill
  • Working out too hard
  • Not stretching before working out
  • Knee arthritis, which can cause your knees to move outward even when your feet are touching, also known as bow legs
  • Faulty biomechanics, like foot overpronation, which is when you over-flatten your feet as you move, which can strain your muscles and tendons
  • Muscle tightness in the buttock, hip muscles, and thigh muscles

How Is IT Band Syndrome Diagnosed?

To diagnose IT band syndrome, your healthcare provider will take a detailed medical history. They will ask you questions about the location of your pain, how long you've had symptoms, as well as what tends to make the pain better or worse.

Your healthcare provider will also give you a physical exam. They may do tests that check for pain in specific areas to confirm your diagnosis. Tests may include:

  • The Ober test, where your healthcare provider will move your knee and hip while you are lying on your side
  • The Noble's compression test, where your healthcare provider will move your knee while pressing on the outside of it

Your healthcare provider may also have you do imaging tests, like an X-ray, which checks for bone and joint issues or breaks, or magnetic resonance imaging (MRI), which checks for ligament and joint injuries.

To diagnose IT band syndrome, your healthcare provider will take a detailed medical history and do a physical examination. Rarely, imaging, like an X-ray, is required to confirm a diagnosis of IT syndrome.

Other Potential Diagnoses

Other diagnoses your healthcare provider may consider include:

  • Patellofemoral stress syndrome, which can cause kneecap and hip pain, and is due to abnormal kneecap rubbing, especially while exercising
  • Lateral collateral ligament tear, which is a ligament tear on the outside of the knee that can lead to knee instability
  • Popliteal tendonitis, which can cause pain or a popping sensation near the back of the knee

Treating IT Band Syndrome

Treating IT band syndrome may include at-home remedies, as well as medication, physical therapy, and in some cases, surgery.

R.I.C.E. Protocol

The R.I.C.E. protocol can be a helpful step to relieve pain from an IT band injury.

  • Rest (or Reduce Activity): Whether you have been diagnosed with or suspect iliotibial band syndrome, your first step should be to rest the affected leg.
  • Ice: Place ice, along with a thin towel, on the outside of your knee for 15-minute sessions every two hours to help with pain and relieve inflammation.
  • Compression: If you have been diagnosed with IT band syndrome, talk with your healthcare provider about wrapping an Ace bandage just above your knee. Compressing this area can help stabilize the knee.
  • Elevation: When icing your knee, try to keep your leg raised above your heart.


Your healthcare provider may recommend taking a nonsteroidal anti-inflammatory (NSAID), such as Advil (ibuprofen) to help with pain.

They may also suggest steroid injections to help with pain and inflammation. This treatment may be considered if a person continues to have pain even after trying the R.I.C.E. method and taking an NSAID.

Physical Therapy

When your pain and inflammation improves, you can begin physical therapy. A physical therapist will use different methods to boost leg strength, mobility, and flexibility.

They're also likely to recommend IT band stretches and other exercises that, under a healthcare provider's supervision, you can do to strengthen your IT band and condition other muscles in the hips and legs.


Surgery is rarely required to treat IT band syndrome. It's usually only recommended if pain continues after at least six months of trying physical therapy, medications, and the R.I.C.E. method.

How Do I Prevent IT Band Pain?

You can prevent IT band irritation by:

  • Replacing your workout shoes when they no longer feel supportive
  • Running in both directions if running on an uneven course or on a track
  • Stretching before and after working out
  • Increasing your workout intensity over time
  • Training on flat surfaces
  • Limiting running or jogging downhill

When To See a Healthcare Provider

It's important to see your healthcare provider for any knee pain that is severe, worsening, or lasts for more than a few weeks. In addition to knee pain, seek immediate medical care if you:

  • Are unable to walk comfortably or have knee locking, which is when you are unable to bend your knee
  • Have swelling or skin changes, like warmth or redness
  • Experienced a traumatic knee injury
  • Have a fever


IT band syndrome can cause symptoms such as knee, thigh, and hip pain that may also burn or ache. The pain may worsen over time and lead to swelling.

IT band syndrome may be triggered by certain conditions, running downhill, wearing non-supportive shoes, and not properly stretching.

Your healthcare provider can diagnose IT band syndrome by taking a detailed medical history, giving you a physical exam, and possibly doing imaging tests.

Treatment may include the R.I.C.E. method, medications, physical therapy, and possibly surgery.

A Word From Verywell

IT band pain may improve if you reduce your activity, stretch, and take an NSAID. In order to prevent this pain from coming back, it's important to figure out what caused it. Be sure to speak with your healthcare provider about other treatment options if your IT band pain continues.

Frequently Asked Questions

  • How common is iliotibial band syndrome?

    It's very common among people who are physically active. IT band syndrome is responsible for 22% of all lower leg injuries in athletes.

  • How long does it take to heal from iliotibial band syndrome?

    This depends on many factors, but some people recover within two to eight weeks after resting, stretching, and taking medications.

  • What is a good stretch for the IT band?

    There are lots of ways to stretch the iliotibial band. This simple standing stretch has been found to be especially effective:

    1. Cross your left leg behind the right, with the hip turned out.
    2. Raise both arms straight overhead and grasp your hands together.
    3. Lean toward your right until you feel a stretch along the outside of your left thigh.
    4. Hold for a count of 15; repeat three times, then switch sides.
  • What kind of running shoes should I choose if I have iliotibial band syndrome?

    There's no one-size-fits-all recommendation for shoes. However, it may be a good idea to see a podiatrist (foot and lower leg specialist) who can figure out what's contributing to your IT band syndrome. They can prescribe a custom shoe insert that may help.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Elizabeth Quinn
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.