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Home > Chronic Pain > ITB Syndrome

ITB Syndrome

ITB syndrome


I overcame ITB syndrome by doing several things.

  1. Stop exercising.  This is a no-brainer for most of us, but for the hard-core cyclist or marathoner, they may need to be told more than once.  ITB syndrome is not going to go away if you try treating ITB syndrome while continuing your exercise regimen.  ITB syndrome took me six weeks to overcome and I stopped exercising immediately and followed all of the classic self-treatment advice.
  2. Ice the hell out of it.  First and foremost, I iced the source of the pain, the ITB where it connects to the outside of the knee.  Use a bag of frozen peas/corn and place it directly on the spot where it hurts for 20 minutes.  It’s easier if you get two thick rubber bands and use those to strap the frozen veggies to your leg, that way you can watch TV or whatever while you’re icing.  And yes, you should lose all feeling in the area about 6-8 minutes into it.  You can safely ice a body part once every two hours.  Icing decreases swelling which improves circulation which brings blood, and with it, nutrients, to the tendon.  You can stop icing when the pain goes away.  I think it took me 2-3 days of icing like 5-6 times a day to get it to go away.
  3. Take a foam roller to it.  Buy a foam roller online.  Some of you are thinking “what the hell is a foam roller?”  I didn’t know they existed until I got ITB syndrome and started researching ITB syndrome online.  Basically a foam roller is a self-massage tool.  You can get one online for 35 bucks.  Don’t get a cheap one.  I tried.  It’s not worth the money you save.  See the Floota.com article on foam rollers for more information.  Floota.com also has an article about how to use a foam roller to fix ITB syndrome (rolling the outside of the thigh).  You can start foam rolling your ITB even before the pain goes away.  Foam rolling does two things for the ITB, (1) it stretches it out and (2) it breaks up scar tissue and “myofascial adhesions” in and around the ITB.  As a side benefit to foam rolling your ITB, you’ll end up really improving the soft tissue quality of your outer quadriceps muscle, the vastus laterales.  Do not foam roll your ITB on consecutive days.  In fact, one of my physical therapists advocated two days of rest before rerolling your ITB (or anything).  The same physical therapist told me that he sees ITB syndrome patients who made their ITB syndrome worse by foam rolling it on a daily basis.  Your body needs time to cart away all the stuff you shook loose when you foam rolled it and repair the tendon.  As a warning: the first time you foam roll your ITB, it will be incredibly painful.  Stick with it.  Day 2 (i.e. 2-3 days after day 1, remember) is easier and day 3 even easier.
  4. Stretch it.  Check out the Floota.com article on stretching your ITB.  You don’t have to wait for the pain to subside before you begin a stretching regimen.

ITB pain

ITB syndrome is tendonitis of the iliotibial band.  The cause of this tendonitis is repeated rubbing of the ITB over the lateral femoral epicondyle (a nub on the outside of your femur above the knee).  On top of this nub is something called a bursa.  You can just think of the bursa as lubrication; a bursa is a fluid-filled sac that sits below tendons in certain parts of the body and allow the tendons to move around without rubbing bones.  When your knee moves through its range of motion it gets to a point where the ITB slides over this bursa.  Normally this isn’t a problem unless (1) the ITB is super tight and (2) you slide it over this bursa thousands of times (as you would if you were running or riding a bike).  Another way to get ITB syndrome is to (A) have a super-tight ITB and (B) put a lot of tension into it and then slide it over the bursa only a few times.  This is how I initially got ITB syndrome.  Having not exercised in months and not knowing that my ITBs were incredibly tight, I decided to bang out about a hundred lunges.  I got ITB syndrome so bad I couldn’t walk without extreme pain.  Common causes include:

  1. Running on a cambered road.  Most roads are tilted such that the middle of the road (where the two lanes meet) is higher than the outsides of the road for drainage purposes.  Thus when running on a road you are running on an incline.  Running on the right side of the road, for example, places your left foot higher than your right which puts unequal forces on your knee and hip joints (and the rest of your body as well).  This isn’t a big deal unless you run on a cambered road regularly.
  2. Running around a track in one direction (e.g. counter clockwise) only.
  3. Having really tight hip extensors (e.g. glutes) and hip flexors (e.g. TFL) and then doing pretty much any exercise that involves your legs.

ITB syndrome causes pain on the outside (lateral) of your knee, or just above the knee on the outside of the thigh.  This pain is emanating from the tendon.  If you’re not sure where in your knee the pain is coming from, you might consider reading the floota.com knee pain article.

Reoccurrence Prevention
You already know that you are prone to ITB syndrome, so if you don’t take preventative measures after you heal, you’re asking for reoccurrence.  Basically, to prevent reoccurrence of ITB syndrome, all you have to do is continue to foam-roll the outside of your thigh and continue to do an ITB stretch on a regular basis.


  1. What is ITBS? @ itbs.info
  2. ITB Syndrome @ eorthopod.com
  3. Iliotibial Band Syndrome @ Wikipedia.org
  4. IT Band Syndrome @ ourhealthnetwork.com
  5. Khaund, M.D. & Flynn, M.D., Iliotibial Band Syndrome: A Common Source of Knee Pain @ aafp.org

Last Updated: 6/22/2009
Originally Posted: 11/10/2008