Lateral Knee Pain When Running: IT Band Causes & Fixes

If you're experiencing a sharp or burning pain on the outside of your knee — typically appearing a few kilometres into a run and forcing you to stop or slow down — there's a very good chance you're dealing with IT band syndrome (iliotibial band syndrome, or ITBS).

It's one of the most common running injuries, particularly among people increasing their mileage or returning to running after a break. The frustrating thing about IT band syndrome is that it rarely responds to rest alone. Here's what's actually going on, and what evidence-based treatment looks like.

What Is the IT Band and Why Does It Get Irritated?

The iliotibial band is a thick band of connective tissue running down the outside of the thigh, from the hip to just below the knee. It's not a muscle — it can't be stretched or strengthened directly — but it is influenced heavily by the muscles that feed into it, particularly the glutes and hip abductors.

The pain associated with ITBS occurs where the IT band passes over the lateral femoral condyle (the bony prominence on the outside of the knee). With repetitive flexion and extension — as in running — this area becomes compressed and irritated.

Contrary to popular belief, IT band syndrome is not caused by a 'tight' IT band rubbing over the knee. Current research points to compression of the fat pad beneath the IT band as the primary mechanism. This is why foam rolling the IT band directly often doesn't resolve it — and why hip and glute strengthening tends to work better.

What Causes IT Band Syndrome?

Training factors

• Rapid increase in weekly mileage

• Excessive downhill running

• Running on cambered surfaces

• Returning to running too quickly after a break

• Inadequate recovery between sessions

Biomechanical factors

• Weak glutes and hip abductors

• Hip drop (Trendelenburg gait) when running

• Knee adduction (knee caving inward) on landing

• Overpronation of the foot

• Leg length discrepancy

In most cases, it's a combination of both — a biomechanical vulnerability exposed by a training load the body wasn't prepared for.

How to Treat IT Band Syndrome

Treatment has two phases: settling the irritation, and addressing the underlying cause. Both matter — treating only the symptoms leads to recurrence.

Phase	Goal	What to do
Phase 1 (Days 1–7)	Reduce irritation	Reduce or pause running. Keep moving with low-impact activity (cycling, swimming). Ice the lateral knee for 10–15 mins post-activity.
Phase 2 (Week 2+)	Rebuild strength	Progressive loading of glutes and hip abductors using resistance bands. Gradual return to running — start with short, flat runs.
Ongoing maintenance	Prevent recurrence	Continue hip strengthening. Monitor weekly mileage increases (10% rule). Warm up properly before every run.

The 5 Best Exercises for IT Band Syndrome

These exercises target the glutes and hip abductors — the muscles most commonly implicated in ITBS. Use a light or medium resistance band. Perform them 3–4 times per week, ideally before your runs as part of your warm-up.

1. Clamshell

Targets: Hip external rotators, gluteus medius

Loop a band just above your knees. Lie on your side, knees bent to 45°. Keeping your feet together, rotate your top knee upward as high as comfortable without your hip rocking back. Lower with control. This is one of the most directly effective exercises for ITBS — don't rush it.

Start with: 3 sets of 15 reps each side

2. Lateral Band Walk

Targets: Gluteus medius, hip abductors, knee stabilisers

Band just above knees or ankles. Quarter-squat position. Step sideways for 10–15 paces in each direction, maintaining tension throughout. Keep your chest up and avoid leaning side to side.

Start with: 3 sets of 12 paces each direction

3. Standing Hip Abduction

Targets: Gluteus medius, tensor fasciae latae

Anchor one end of the band to a fixed point at ankle height. Loop the other end around the ankle of the leg furthest from the anchor. Stand tall and lift the banded leg out to the side against the resistance. Lower slowly. Keep your pelvis level throughout.

Start with: 3 sets of 12 reps each side

4. Glute Bridge with Band

Targets: Glutes, hamstrings, hip stabilisers

Band just above knees. Lie on your back, knees bent, feet flat. Press your knees slightly outward against the band, then drive your hips up. Squeeze the glutes hard at the top and hold for 2 seconds. The band adds hip abductor activation on top of the glute load.

Start with: 3 sets of 15 reps

5. Single-Leg Glute Bridge

Targets: Glutes, hamstrings, hip stability

No band needed for this one. Lie on your back, extend one leg straight, and perform a single-leg bridge. Focus on keeping the pelvis level — any drop to the unsupported side indicates weakness in the hip stabilisers on the working side. Progress to this once the bilateral bridge feels easy.

Start with: 3 sets of 10 reps each side

When to See a Physiotherapist

If your symptoms aren't improving after 4–6 weeks of the above, or if you're experiencing sharp pain rather than a dull ache, a physiotherapy assessment is worthwhile. A physio can assess your running gait, identify specific biomechanical contributors, and tailor a programme to your individual presentation.

Don't try to run through significant IT band pain. Unlike muscle soreness, which often eases with warm-up, ITBS pain typically worsens during a run and can set recovery back significantly if you push through it repeatedly.

Frequently Asked Questions

How long does IT band syndrome take to heal?

With appropriate management — load reduction, targeted strengthening, and gradual return to running — most cases resolve within 6–12 weeks. Without addressing the underlying causes, it tends to recur.

Should I foam roll my IT band?

Foam rolling the IT band directly is unlikely to resolve the problem, as the IT band itself is too dense to be meaningfully altered by foam rolling. Rolling the glutes and TFL (the muscle above the hip) is more productive. If the lateral knee is acutely inflamed, avoid direct pressure on the area.

Can I keep running with IT band syndrome?

In the acute phase, reducing or pausing running is advisable. Short, flat runs may be tolerable as you recover, but significantly downhill running should be avoided. Return to full running gradually, monitoring symptoms carefully.

Is IT band syndrome the same as runner's knee?

No. Runner's knee (patellofemoral pain) causes pain at the front of the knee, typically around or behind the kneecap. ITBS causes pain on the outside (lateral side) of the knee. Both are common running injuries, but they have different causes and treatments.

Support Your Recovery at Home

flexa.fit resistance bands are available in five resistance levels — ideal for progressing through your ITBS rehabilitation programme at your own pace. Latex-free and used by physiotherapy clinics across the UK.

Shop Resistance Bands at flexa.fit →