January 13, 2016

More people each year are participating in local 5k's, 10k's, half-marathons, and beyond in hopes of reaching personal goals and maintaining a healthier lifestyle.  While the summer months usually have the most participants in local races, training for those events will likely begin during the winter months. Icy Kansas City temperatures during the winter months force runners to begin their training indoors on the treadmill, which can cause muscle imbalances that may eventually result in pain. Champion Performance and Physical Therapy would like to take this time to review some prevention and treatment concepts for a common overuse running injury referred to as Iliotibial Band Syndrome (ITBS), and help our local runners accomplish their goals this year!

What is the Iliotibial Band?

The IT band is a part of a group of muscles on the outside of the hip that serve to promote hip stability during running, restraining the leg from crossing midline when the foot hits the ground. The band starts at the hip area (the ilia) and crosses the outside of the knee joint to insert on the tibia (shin bone) of the lower leg.

How does ITBS occur?

If a runner has muscle imbalances due to weakness or tightness, abnormal running mechanics may occur. Altered running mechanics can cause the band to rub over the underlying bone with repeated knee flexion and extension. The resulting friction can lead to inflammation and irritation.

What are the causes of ITBS?

  • As mentioned above, ITBS can be caused by muscle imbalances* such as excessive muscle tightness or weakness. 
  • Training errors: A runner who increased mileage too quickly, does too many hills, or runs on one side of a beveled road (which is slanted for drainage) is at greater risk for ITBS
  • Incorrect shoes: A shoes that does not adequately control pronation or supination can also be a cause of ITBS

*A muscle imbalance would mean that one group of muscles is too tight, too strong, or too weak to match that of it's counterpart/antagonist muscle group. 
A counterpart/antagonist muscle group would be the equivalent of what the triceps are to the biceps - the group of muscles that act on the bone, pulling in the opposite direction.

How can I prevent ITBS?

  • Try changing your running routine. Instead of running only on a treadmill or a track, go for a run outdoors (if you can bare the weather), or run on a carpeted surface with more "give". Change the side of the street you run, cross training might also help to alleviate symptoms.
  • Stick to a schedule for increasing mileage and remember: not too quickly!
  • Stretch, stretch stretch!
  • Change your shoes as needed to prevent stress to ankles, hips and knees and maintain integrity of the tread.

How can I treat ITBS if I have it?

  • Self soft-tissue mobilization: Foam rollers, tennis balls, and lacrosse balls are good methods of improving soft tissue mobility.
  • Include exercises in your training routine that will strengthen your hip abductors
  •  If this strategy does not help, contact the experts at Champion Performance and Physical Therapy and we can assess your running shoes, flexibility, and strength and design a program to meet your individual needs.


[i] Hamill J, Miller R, Noehren B, Davis I. A Prospective Study of Iliotibial Band Strain in Runners; Clinical Biomechanics [serial online]. April 2008.
[ii] van der Worp M, van der Horst N, de Wijer A, Backx F, Nijhuis-van der Sanden M. Iliotibial Band Syndrome in Runners: A Systematic Review; Sports Med [serial online]. 2012.
[iii] Baker R, Souza R, Fredericson M. Iliotibial Band Syndrome: Soft Tissue and Biomechanical Factors in Evaluation and Treatment; American Academy of Physical Medicine and Rehabilitation [serial online]. June 2011.