IT Band Syndrome in Runners

IT band syndrome is pain on the outside of the knee caused by irritation where the iliotibial band, a band of connective tissue running from the hip to just below the knee, repeatedly moves over the outer knee bone during running. It's a common overuse issue in distance runners and tends to build gradually with mileage rather than appear from a single incident.

What IT band syndrome actually is

The pain typically sits on the outer side of the knee and often has a distinct pattern: fine at the start of a run, then a sharp or burning sensation that builds after a few kilometres, sometimes forcing a stop. It's generally linked to repetitive friction and irritation rather than a single structural injury, which is part of why it responds well to changes in training load and strength rather than rest alone.

Common causes

• A sudden increase in mileage, especially longer runs
• Weakness in the hip muscles that stabilize the leg while running
• Consistently running on a cambered road or the same direction on a track
• Worn shoes that no longer provide consistent support
• Limited variety in training surfaces and routes

General management approaches

Reducing mileage, or temporarily cross-training with cycling or swimming, is a common first step while symptoms settle. Hip and glute strengthening tends to be one of the more consistently recommended approaches, since a stronger hip complex generally reduces the strain on the IT band during the running gait.

Varying your routes and surfaces where possible, and checking that your shoes are still providing adequate support, see how to choose running shoes for your first race, can also help reduce repetitive strain. A consistent warm-up and mobility routine is worth building in too; see stretching before and after running.

Returning to running

Once pain has settled, most runners find it helpful to reintroduce mileage gradually and pay attention to whether the familiar pain pattern returns at a similar point in the run. Shortening runs slightly and building back up over a few weeks tends to work better than jumping straight back to a previous long-run distance.

When to see a doctor or physiotherapist

If pain persists despite reduced training, comes on earlier and earlier in each run, or doesn't improve over a few weeks, it's worth seeing a doctor or physiotherapist rather than continuing to guess at a fix. They can assess hip and leg strength properly and build a more targeted plan than general advice can offer. For an overview of other common overuse injuries, see common running injuries.