IT Band Syndrome

IT band syndrome is typically a hip problem disguised as a knee problem. Weak glutes, particularly the gluteus medius, fail to control your thigh position during running and walking. When your hip drops on one side during single-leg activities, it causes your thigh to angle inward (hip adduction), which increases tension in the IT band and compresses the sensitive tissue underneath it at the knee.

Running mechanics play a huge role in developing IT band syndrome. Overstriding (landing with your foot too far in front of your body), excessive crossover gait (feet landing across the midline), and running with too much vertical oscillation all increase IT band tension. Downhill running is particularly problematic because it encourages longer stride lengths and places greater demands on your hip stabilizers. When your hip muscles fatigue, your running form deteriorates, creating even more IT band stress.

Training errors compound the biomechanical issues. Sudden increases in mileage, running primarily on cambered roads (which creates uneven leg lengths), or consistently running in the same direction on tracks forces your body to adapt to asymmetric loading patterns. Tight hip flexors from prolonged sitting limit hip extension during running, forcing your IT band to work harder to stabilize your pelvis. Even factors like leg length differences or old ankle injuries can alter your gait pattern enough to overload one IT band. The key insight is that the IT band itself is rarely the problem - it's usually responding to poor control from the hip above.