IT band pain, or pain in the outside of your knee, is a common injury among walkers and runners. IT (iliotibial) band pain is usually caused by repetitive stress, high-impact exercise, or poor walking posture and form. Recurring knee pain can make it hard to walk every day, or hard to walk for long periods of time when you do walk. Fortunately, most IT band pain can be treated without surgery or physical therapy. Stretches and exercises to strengthen and limber up your knees, hips, and glutes can also help avoid pain.
If you’re feeling pain in the outside of your knee that seems to recur when you walk (or need to bend your knees a lot), IT band pain could be the cause. Here are some common causes of IT band pain, treatment options for minor issues, and exercises to help prevent IT band pain in the future
*Note – for any new or worsening pain, make sure to see a doctor. Your doctor can make sure it’s nothing serious that may require more intensive treatment.
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What is IT band pain?
The IT band or Iliotibial band is a thick band of connective tissue that runs from your outer hip down to the outside of your knee. Irritation and inflammation of this tissue can lead to pain called IT band syndrome (ITBS). If you are wondering if the knee pain you are experiencing is due to ITBS, Shape magazine explains that IT Band-related pain is worse when the knee is bent at a 20-30 degree angle (close to the angle of your knee when running or walking). You will feel the pain on the outside of your knee, but not the kneecap itself and it will be made worse by activities like walking up and down stairs, running or squatting down.
How do you develop IT band pain?
IT band pain is usually described as a repetitive strain or overuse injury. According to WebMD, it’s usually caused by repeated bending and straining of the knee. Activities like running, hiking, and walking can cause this pain over time. Your IT band should slide and move as you walk, but some people’s IT bands are too tight, which causes them to rub against the knee and become irritated and painful. IT band pain is usually not caused by a single sudden slip or tweak of your knee.
It’s also important to note that the IT band is located on the outside of your knee (the right side of your right knee, for instance). Pain in the inside of your knee (left side of your right knee) or inside the knee itself could be a more serious ligament injury, so make sure to consult a doctor just to be sure.
Some common reasons why people might develop ITBS according to Runner’s World are:
- Repeatedly engaging in activities that cause inward rotation of the leg such as running downhill or wearing worn-out shoes
- Overtraining by increasing your mileage too quickly or at too sharp an incline
- Weak gluteal muscles, or weakness in other knee or leg muscles
- Women have wider pelvises, which put greater stress on the IT band
Other reasons for developing IT band pain according to Healthline are:
- Prolonged sitting, or time in a posture with bent knees
- Using poor form or posture
- Not properly warming up or cooling down before exercise
How is IT band pain treated?
Fortunately, IT band pain can usually be treated through over-the-counter remedies, physical therapy or strengthening the muscles of the leg. Unlike ligament injuries or some other types of knee injuries, IT band pain rarely requires surgery or major interventions. Of course, if you experience new or worsening pain, make sure to see a doctor. Your doctor can diagnose the source of your pain and design a treatment plan for your particular problem.
As with most sports-related injuries, it’s important to rest and let your body heal. Although daily walking is very important, when injured it’s very important to take a break for at least a few days to give your body a chance to heal. When you do get back to walking, try to limit your steps and see how your knee responds. It may take a day or two of walking before you start feeling the IT band soreness again, so walk less than you normally would for a few days. If you’re feeling pain-free after a few days of walking, gradually increase your steps slowly. Don’t forget that rest and recovery includes better sleeping habits!
Ice and/or heat
Ice can help to relieve pain and decrease inflammation, while heat packs can increase blood flow to the affected area. There’s a long-running debate about whether heat or ice is better, so see how your body feels. Make sure to use ice for no longer than 10-15 minutes at a time and heat for no longer than 20 minutes. Make sure not to apply ice directly to an injured area, but wrap your ice pack with a towel to prevent frostbite.
Also remember that ice and heat can relieve pain and inflammation, but don’t treat the underlying IT band injury. Don’t try to push yourself to walk too much, too quickly just because your knee feels better after icing it. Rather, heat and ice can help with pain and discomfort so you feel a bit better after walking.
If your IT band pain persists, or if you’re having trouble increasing your steps due to pain, look into other low-impact exercise activities. Water aerobics (or other forms of water exercises), swimming, gentle yoga or pilates are great choices. Exercises that can stretch your joints and strengthen your leg muscles can help to alleviate pain and prevent it in the future. Be sure that your rest day exercise or exercise during your time off to heal really is low-impact. Otherwise you can simply make your IT band pain worse.
Gentle stretches can also keep you limber while you take a break from walking. Just remember to keep it easy with only your own body weight as resistance until your pain subsides. Make sure to warm up before stretching, with some light activity that gets your body moving. Stretching a joint that’s completely cold and not warmed up can result in further strain or injury. Keep it light as well. You shouldn’t be feeling pain, but instead a gentle stretch.
How Can You Prevent Future IT band Pain?
The root cause of IT band pain is often weak gluteal muscles or leg muscles or poor walking posture with an uneven gait. Exercises focused on strengthening these trouble spots may prevent future injury. Prevention.com recommends “healing exercises to strengthen and loosen the surrounding muscles” such as these exercises.
While standing on one leg, lift the opposite leg off the ground. Put your hands on your hips, and bend the knee of the lifted leg. Try to stand on one leg in this position for up to 30 seconds, then switch legs. If you’re just starting, you can try holding onto a chair or other object for balance. Beginners can also place your leg on a chair or other object instead of holding it in the air.
More advanced exercises can try holding the lifted leg straight out in front of you with your foot flexed backward towards your head.
Single leg balance guide from the Mayo Clinic
Side leg raises
There are two ways to do this exercise.
Standing – Stand with your legs together in good posture with your hands on your hips. raise one leg out to the side of your body (your right leg moves right, for instance). Go as far out as you comfortably can, or to a 45-degree angle, then return to center. Do this 10-12 times for each leg.
Lying down – Lie down on your side with your head propped up on your elbow. If you’re lying on your right side, raise your left leg out to the side of your body (directly up towards the ceiling in this case). Go as far as you comfortably can or to a 45-degree angle, then return. Again, do 10-12 of these and then switch sides.
Side leg raise guide from Healthline.com
Start lying down on your back with your arms to your side palms facing down and your feet fairly close to your butt. This should place your knees facing up in the air. Lift your hips off of the ground until your knees, hips and shoulders form a line (or as high as you comfortably can go if you can’t reach that high). Hold the position for a few seconds, then slowly return back to the ground. Keep your abs and glutes engaged during this exercise to protect your back.
Guide on the hip bridge from Coachmag.co.uk
Examine Your Walking/Running Habits
Your shoes may look nearly new but if you’ve put hundreds to thousands of miles on them, the soles and insoles may be wearing unevenly. While you can walk in non-walking shoes, if you’re experiencing pain you should look into a proper pair of walking shoes. If you’re running or hiking, make sure to get shoes for those specific activities. You may want to have a doctor or specialist at a shoe store look into whether you need special shoes or a special insole for arch or other foot problems.
Search for a flat walking path with an obstacle-free surface. Hiking or walking on uneven terrain can lead to IT band pain or make it worse due to your legs often bending in different angles to handle bumps or obstacles. Try to avoid incline walking or walking up and down stairs when IT band pain is flaring up, as it’s higher impact on your knees. If you can find a walking track, or other softer but uniform walking surface, it can be easier on your knees – especially if you’re walking for long periods of time. Track walking can sometimes be a bit repetitive, but bring along an interesting podcast and the walking time can really fly.
Have someone video record you walking or running or have a friend or personal trainer watch you while training. You may be able to pick up on gait abnormalities that could be putting undue strain on your IT band. Watch for signs such as bowlegged walking or not standing straight and try to correct those if possible.
Focus on maintaining perfect posture throughout your entire walk. If you feel yourself begin to tire or to start to slouch, cut your walk short. Bad posture can lead to strain on muscles throughout the body, including your knees.
Remember that IT band syndrome is one of the most common injuries experienced by athletes and active people. Suffering an IT band injury doesn’t mean the end of your new healthy and fit lifestyle, it just requires being more mindful of ways you train smarter.
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