What is IT band pain?
The iliotibial (IT) band is a thick strip of connective tissue that runs down the outer thigh, from the hip to just below the knee. It helps stabilise the leg when you run, cycle or walk. IT band pain is a sore, sensitive area on the outer knee, or sometimes the outer thigh, where the band is overloaded.
It is a common cause of outer knee pain in runners and cyclists, and the ache builds the longer you go.
What does it feel like in everyday Ipoh life?
The pain is a sharp or burning ache on the outer side of the knee. It may start at a similar point on each run or ride, then ease soon after you stop.
Running along the Polo Ground or a long ride up toward the hills can bring it on. Downhill sections on Bukit Kledang, and long slow walks that slope off to one side, can aggravate it.
In the heat, runners can push through when they should shorten the outing. The pain usually settles by the next day, so it is easy to repeat the same mistake.
Who is it most likely to affect?
It is most common in runners and cyclists, especially those who have increased distance or hills quickly. Hikers and people who play sports with a lot of knee bending can get it too.
Weak hip and buttock muscles can add to the load. So can a change of shoes, a saddle set too high or too low, or running on a sloping road. It is rarely a sign of damage inside the knee.
What does a physiotherapist check first?
We ask about your training, the route, your shoes or bike set-up, and when it began. Then we examine the knee, hip and foot.
We check:
- where the outer knee is tender.
- the strength of the hip muscles that hold the pelvis level.
- how the knee and hip move when you squat and step down.
- stability on one leg, and how you run or ride.
- other causes, such as a meniscus tear or pain from the outer hip.
If anything points to another problem, we say so and refer you on.
What helps IT band pain?
The main treatment is building the strength and control of the hip and thigh, with sensible changes to training load. Recovery varies between people, and we review progress at each visit.
A plan can include:
- strengthening the hip muscles on the outside and back of the pelvis.
- single-leg control exercises, then step-downs and lunges.
- shorter, flatter sessions that stay below the pain, then a gradual build up.
- changes to shoes, saddle height or cleat position, where relevant.
- hands-on techniques to ease tight muscles around the hip.
For more on runners and the weather, see running in Ipoh’s heat.
What can I do this week?
Keep moving, but keep the load below the point where it hurts.
- Shorten your run or ride, and stop before the ache builds.
- Run on flat ground, and avoid long downhill stretches for now.
- Train early or late, when the day is cooler.
- Check that your shoes are not worn on one side.
- Do side-lying leg lifts and gentle bridges, a few times, once a day.
Stop an exercise if it leaves the pain sharper for more than a few hours.
When should I see a doctor first?
Go to the emergency department if the knee swells quickly after an injury, locks or cannot bear weight. Go too if it is red, hot and swollen with a fever.
See a doctor if the pain is constant at rest, wakes you at night, or does not improve after a few weeks of sensible changes. Hospital Raja Permaisuri Bainun, Fatimah Hospital and Pantai Hospital Ipoh can see you.
How do home sessions in Ipoh work?
A physiotherapist visits your house, examines the knee and hip and watches you squat, step and balance. We build the strengthening plan on your own floor and stairs.
Visits across Ipoh are available now, and our Canning Garden centre near Fatimah Hospital is opening soon. Prices are quoted on WhatsApp after a short description.
Read how home physiotherapy works, the wider page on knee pain, and the blog on cycling knee and back pain.