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While runner’s knee gets plenty of attention, another common injury can cause knee pain in new and experienced runners alike. Iliotibial band syndrome, also called IT band syndrome (ITBS), typically causes pain on the outside of the knee.

In The Runner’s World Guide to Common Running Injuries, an exclusive program hosted by Winnie Yu, PT, DPT, CSCS, our medical experts explain what contributes to ITBS, how to address your symptoms, and how to safely return to running.

In The Runner’s World Guide to Common Running Injuries: IT Band Syndrome, we’ll teach you:

• Underlying causes of IT band syndrome, what it feels like, and how it differs from other knee pain
• Stretching and strengthening exercises that target the areas around the IT band
• How acting early can keep a mild case of ITBS from turning chronic
• How to return to running gradually and reduce the risk of further pain

Understand the Injury

The iliotibial band is a thick strip of connective tissue that runs from the outside of your hip down to the outside of the knee. “[It helps] stabilize both the hip and the knee during our running gait,” explains John Vasudevan, MD. “But sometimes there is too much friction where that IT band is rubbing over the outside of the knee.”

Several factors may contribute to ITBS. For some runners, there’s a structural reason. For example, a leg-length discrepancy can result from a previous fracture or be related to scoliosis in the spine, causing an imbalance between the hips and therefore the lower legs.

Most commonly, though, ITBS involves a combination of training load and mechanics.

Underlying causes of ITBS:

• Weak glute muscles
• Pelvic imbalances
• Training issues

How Serious Is It?

The severity of your symptoms—and how they respond as you run—can help determine your next steps.

🟢 Green Flag

• The pain you experience during your run responds to a period of rest and stretching
• The pain might persist to a small degree but doesn’t get actively worse during your run

🟡 Yellow Flag

• Your pain gets worse as your run continues
• Your pain begins at an earlier point during each subsequent run

🔴 Red Flag

• You experience swelling of your knee, which isn’t typical of ITBS and may indicate another injury
• You experience numbness or tingling around the knee or elsewhere in your lower leg
• You notice significant snapping or a feeling of instability on the outside of the knee

Recover and Return to Running

“Most of my IT band rehab usually involves a lot of glute and hip strengthening,” says Yu. “These are the major hip stabilizers that can really help reduce some of the strain that’s being placed onto that IT band.”

If you’re experiencing ITBS, Yu recommends performing the following exercises daily or at least three to four times per week.

Dynamic Glute Stretch in 90-90

Hip Switches

Standing Fire Hydrants with Miniband

Curtsy Lunge

Lateral Lunge

❌ Common recovery mistakes:

• Foam rolling directly on the IT band rather than along the outer quad muscle
• Taking a brief break from running before immediately returning to previous mileage rather than making a gradual return

Stay Healthy and Run Stronger

Many of the exercises used during your rehab program can be part of your prehab program. “Doing adequate hip mobility and hip strengthening exercises within your routine not only helps to make the outer muscles of the hip and knee stronger but also helps reduce your risk of developing IT band syndrome as you build up your training,” explains Yu.

Once these exercises feel comfortable, you can add more targeted, lower-body strengthening exercises into your training routine.

Recovery tools to integrate into your routine:

• Foam roller
• Massage gun

Ready to build a stronger, more resilient running routine?

Whether you're beginning to run or you're training for that next marathon, the Runner’s World Guide to Common Running Injuries will help you spend less time sidelined and more time doing what you love. You’ll learn how to recognize the signs of common running injuries, understand their causes, and determine when you can safely modify your training versus when it’s time to seek medical care. This holistic program is available exclusively to Runner’s World+ members and launches on October 6!