5 things you need to know about your IT band

The IT band is the bane of many a runner’s life, especially if you end up with IT band syndrome - sharp, stinging or nagging pain on the outside of the knee. But still, it’s not well-understood by many of us. What actually makes your IT band tight? Can – and should – you stretch and foam roll it? In fact, what even is your IT band?! We asked Dr Rebecca Robinson, consultant physician in Sports and Exercise Medicine at Harley Street’s Centre for Health and Human Performance to clear up the mystery.

What is the IT band?

‘The IT band is a tendon-like structure, a thickening of fascia (the layer of connective tissue that surrounds muscles) that runs from the tensor fascia latae (the TFL, the muscle in front of the hip joint) and gluteus medius down the outside of the thigh to the side of the knee,’ Robinson explains. ‘It inserts at the knee joint, then continues down and attaches to the tibia (the larger bone in your lower leg). It’s not really a muscle. It’s not similar to other tendon structures in the body - it has a little less give in it.’

What causes IT band pain if it’s not because the IT band itself is tight?

IT band pain is caused by friction against the lateral femoral epicondyle – the outer edge of the knee joint - which is usually a result of the TFL overworking to compensate for underactive gluteal muscles. Many of us are victim to lazy glutes thanks to hours spent sitting at work every day, but how can you tell if you’re affected?

‘Seeing a physio can be helpful as it can be quite hard to know if you’re engaging the glutes,’ says Robinson. 'You can do self tests and things like bridging exercises, trying to make sure the glutes are actually working and firing first, but sometime that awareness of what the glutes are doing can be difficult if you’re not used to firing correctly.’ If you visit an experienced physio, they’ll watch you running or doing movements like step-ups to gauge how active your glutes are.

Is it possible to stretch your IT band?

‘This is a contentious point among runners,’ says Robinson. ‘You can’t really stretch the IT band, but you can stretch the muscles around it.’ It’s true - despite what has been believed in the past, research published in the Scandinavian Journal of Medicine & Science in Sports has now found that the IT band itself is minimally affected by stretches, though the stretching of the TFL and gluteus maximus can help relieve tension.

Should you foam roll your IT band?

You can, but whether it’ll help or not is a different matter. ‘If your IT band is already irritated, foam rolling it directly can actually make it worse. People can be a bit overenthusiastic with foam rolling and that can traumatise the IT band.’ Still, that doesn’t mean foam rolling is a waste of time when it comes to treating IT band symptoms. ‘You can ease out some of the muscles that connect around it – the TFL, glutes and the vastus lateralis (the outer quad muscle, which sits beneath the IT band) with rolling though. Runners should also focus on stretching and reconditioning.’

What kind of cross-training can I do with IT band syndrome?

If you’ve got IT band syndrome, running will be painful and, chances are, not very enjoyable. Robinson recommends that sufferers stop running temporarily to give their bodies a chance to heal. ‘It’s possible to cross-train and maintain fitness effectively with aqua running as it’s non-weight bearing. Pay attention to good form as if you were running on land.’

Cycling can be useful too, but ensure a good bike fit. Remember both runners and cyclists can get IT band syndrome, so if you start cycling and you’ve got tight muscles then going hard on the bike may make things worse,’ warns Robinson. ‘If any activities aggravate your symptoms, don’t be afraid of total rest.’

Of course, you’ll want to get back to running as soon as possible, so it’s important to get to the bottom of your IT band troubles. Robinson suggests seeking expert advice: ‘A good sports medicine or physio assessment can identify whether running form, weak and/or tight glutes or tightness in the pelvic/thigh muscles are contributing factors to your IT band pain and show you how to address these. Invest some of your time off running in the gym, to address any underlying weaknesses. Also, remember that even if you’re not training as normal, good nutrition and getting enough sleep will support your recovery from injury faster.’