Causes of IT band pain

The illiotibial band (commonly called IT band) is a thick strip of connective tissue that connects several muscles on the outside of the thigh. It extends from the outer hip to the outer shin, and although it is not a muscle, tightness in this band affects the muscles it connects, and also destabilizes the knee.

Why does it get tight? Two reasons: overuse (of the muscles that it connects) and poor stretching.

Overuse

The tensor fascia latae (TFL)  is a small, strap-like muscle on the outer hip and thigh that inserts between layers of the IT band. Tightness in the TFL is extremely common in runners and cyclists, with related tightness in the piriformis (a deep hip rotator). I typically observe accompanied, related weakness in accessory muscles (usually an underdeveloped gluteus medius, a muscle of the upper, outer butt).

This overuse and tightness in the TFL pulls on the IT band and can result in pain in the lateral knee (outside edge of the joint). A good postural coach or a structural alignment expert can help determine why you’re building strength unevenly. I have noticed it is often related to the feet rolling in or out, the effects of which gets magnified with the repetition of running and cycling.

Ineffective Stretching

Most athletes I meet — whether runners, cyclists, yogis or dancers — do a fine job stretching their hamstrings and quadriceps (the fronts and back of legs), decent work with their hip flexors (ok, this could usually use some tuning up), and completely miss opening the IT band, glutes, and piriformis.

It's not hard to do better. There’s a lot of info on the web about using a foam roller for IT band relief. But without smarter stretching, you’re unlikely to make a lasting change. 

Below is a video with my go-to stretches to ease the IT band and get your knees back to pain-free functioning, plus a step-by-step guide on how to perform each stretch. (Be mindful to avoid hyperextending your knees in your stretches.)

Modified Pyramid Pose (0:12): stagger your feet hip width and step your left foot back about 3 feet. Fold your spine over your front leg (bend your knee if your hamstrings are stiff). Then walk your hands to the right, crossing over your front leg. Lift your back heel as you go, and slide your belly to the right. Repeat on your second side.

Crossed Leg Forward Fold (0:19): Moving from the above stretch, shorter your stance slightly. Bend your knees a couple inches and with your legs toned, press your inner and outer feet down evenly as your wrap your outer thighs and hips back. Do both sides.

Revolved Half Moon (0:30): Stand on your right leg with your left leg extended behind you, parallel to the floor. Place your left hand on the ground under your shoulder, and twist your torso to the right, tacking your right hip back as you go. Do the other side.

Cow Face Variations (0:43): Sit with your knees bent, stacking your knees on top of each other, shins and feet equidistant from hips. If your pelvis tips back, elevate your hips. Explore walking your hands to either side, twisting both directions, to access the top and bottom leg. Repeat with the other knee on top.

Happy stretching. Let me know how it goes!

Justicia DeClue (E-RYT 500) has been teaching since 2005 and is the owner and director of Maha Yoga Studio in Philadelphia. She is most sought after for her detailed alignment instruction and open-hearted teaching style. Follow her on Instagram, Twitter, or Facebook.


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