February 16, 2021

5 Reasons Your Iliotibial Band May Hurt

Iliotibial (IT) band syndrome is something many runners have likely experienced at some point.

Susan Nowell

Iliotibial (IT) band syndrome is something many runners have likely experienced at some point during a run.

If you’ve ever felt pain along the outside of your hip/leg that worsens when you hit the roads or trails, it may be IT band syndrome.

In this post, we will discuss 5 reasons your IT band may hurt and provide answers on how to treat it.

We’ve consulted with top PTs to discuss each reason more in-depth, so let’s dive in!

What Is IT Band Syndrome?

IT band syndrome is a frequent health issue characterized by pain on the outside of the knee along with your IT band. Your IT band is a long tendinous structure that runs along your outer leg, from your hip to your knee. It is frequently a persistent, repetitive strain injury that causes pain, particularly while descending stairs and hills. This long band of flexible connective tissue reaches from the hip to the knee. Overuse and repetitive extension and flexion of the knees are the most common causes of this type of injury. For this reason, runners often experience IT band syndrome.

We’ve consulted top physical therapists to tell you the most common running form errors that lead to IT band pain.

1. Running On Cambered Roads

Roads are typically not level, but designed with a camber, or angle, to aid with water drainage. When you run on a cambered road, your foot lands slightly sideways, increasing the runner’s risk of injury. A good tip is to switch sides on the road you run on frequently. For example, if you run the same 3-mile loop clockwise, try running it clockwise to adjust the camber you’ll experience. Alternate each run with this in mind.

2. Excessive Downhill Running

Downhill running can cause muscular and connective tissue damage in the lower limbs due to strenuous conditions. When you run downhill, your muscles are working harder in a lengthened position as they work to decelerate forces against gravity.  Your ITBand is working to decelerate the forces at your knee when you run downhill, and this places greater friction on the ITB and attachment on the outside of your knee.  as they do when you run uphill, which causes greater wear and strain on your body. Try to mix your runs with some hills and flat roads to give your muscles variation.

3. Crossing Midline At Foot Strike

If you drew a line on the ground straight down from the center of your pelvis, one or both of your feet MAY midline upon foot strike. Many professional and high-level runners cross the midline. Unfortunately, crossing midline can place greater stretch on the ITB, thus leading to increased friction and risk for getting ITBand friction syndrome. (*Not everyone has one or both feet that cross the midline).

4. Overstriding

Overstriding occurs when a person takes larger steps than necessary, commonly with a heel strike and the shin angled backward. It’s best visualized from the side, where you can see the angle of the shin and how far the foot is away from your body’s midline at the time of foot strike. In this position, the heel, shins, and knees are subjected to higher impact forces because the muscles don’t have as much chance to attenuate forces, thus increasing the possibility of injury.

5. Inward Knee Deviation

Inward knee deviation can place extra stress on the knee joint, but it also places a greater stretch on the ITB, thus leading to increased friction and risk for getting ITBand friction syndrome. Possible causes are weak hip musculature and over-pronation of the ankle. Try strengthening your hips by performing clamshells, wall slides, and crab walks (need pictures). You may also need a medial wedge shoe insert to stop your ankle from overpronating.

Final Thoughts

We hope this post gives you some relief from that pain you may have experienced recently in your hip. Having pain sideline you from running can be frustrating. Give these suggestions a try and cheers to happier and healthier running ahead! Still having pain with these suggestions, click here to learn why it might be time to schedule a visit with a Physical Therapist.

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