It occurs when the connective tissue (ligament) extending from the pelvic bone to the shinbone becomes so tight that it rubs against the thigh bone. Distance runners are especially susceptible to it. If you’ve got a nagging pain on the outer part of your knee, especially if you’re a runner, it could be a symptom of Iliotibial band (IT band) syndrome. It’s an injury often caused by activities where you bend your knee repeatedly, like running, cycling, hiking, and walking long distances.

What is IT (Iliotibial Band) band?

IT band or Maissiat's band is a thick bunch of fibers that runs from the outside of your hips to the outside of your thigh and knee down to the top of your shin bone.

What Is Iliotibial Band Syndrome?

If your IT band gets too tight, it can lead to swelling and pain around your knee. The problem is friction where the IT band crosses over your knee. A fluid-filled sac called a Bursa normally helps the IT band glide smoothly over your knee as you bend and straighten your leg. But if your IT band is too tight, bending your knee creates friction. Your IT band and the bursa can both start to swell, which leads to the pain of IT band syndrome.

Who Gets It? What Causes It?

  • Not using the right training techniques.
  • Not doing enough to stretch, warm-up, and cool-down
  • Pushing too hard -- you go too far or for too long not resting long enough between workouts.
  • Wearing worn-out sneakers running or training on the wrong surfaces. 
  • Running or training on the wrong surfaces.
  • Running downhill.
  • Running only on one side of the road. Because roads slope toward the curb, your outside foot is lower, which tilts your hips and throws your body off. 
  • Training on banked, rather than flat, surfaces. Most running tracks are slightly banked.

Some traits raise your chances of getting IT band syndrome:

  • Bowed legs 
  • Knee arthritis 
  • One leg that’s longer than the other rotating your foot or ankle inward when you walk or run. Rotating your whole leg inward when you walk or run. 
  • Weakness in your abs, glutes, or hip muscles. 

What are the Symptoms?

The main symptom is pain on the outer side of your knee, just above the joint. Early on, the pain might go away after you warm up. Over time though, you may notice it gets worse as you exercise. 

Other symptoms include: Aching, burning, or tenderness on the outside of your knee.

Feeling a click, pop, or snap on the outside of your knee

Pain up and down your leg.

Warmth and redness on the outside of your knee. 

How Will My Doctor Test for It?

Typically, your doctor can tell you have IT band syndrome based on your symptoms, health history, and a physical exam. It’s not the only cause of outer knee pain, so you may get an X-ray to rule out other causes.

How Is It Treated?

If you closely follow your doctor’s orders and give yourself the rest you need, you can usually recover from it in about 6 weeks. 

Don’t do activities that trigger the pain. 

Take over-the-counter pain relievers. 

Wrap an ice pack in a towel and put it on the outside of your knee for 10-15 minutes at a time. 

A physical therapist can give you tips for:

  • How to best warm-up and cooldown.
  • Help you choose footwear and if you need them, shoe inserts 
  • Show your exercises to help strengthen and stretch your IT band and leg muscles.
  • Talk to you about how to adjust your training schedule.
  • Teach you how to improve your form to go easier on your body.


Use friction massage, ice, or ultrasound to help with pain and swelling. That usually does the trick, though some people need cortisone injections to help with pain and swelling. 

How Can You Prevent IT Band Syndrome?

To help prevent IT band syndrome, you can: 

  • Allow plenty of time to properly stretch, warmup, and cool down. 
  • Give your body enough time to recover between workouts or events. 
  • Run with a shorter stride. 
  • Run-on flat surfaces or alternate which side of the road you run on. 
  • Replace your shoes regularly.
  • Stretch your IT band, hip muscles, thigh muscles, and hamstrings often.
  • Use a foam roller to loosen up your IT band.