Running-Related IT Band Muscle Pain Explained

Running-related IT band muscle pain is common in runners, but the exact cause of the condition could be due to a number of things, such as faulty biomechanics. Unfortunately however, studies have failed to associate foot strike type (forefoot strike vs heel strike) with iliotibial band syndrome (ITBS). What we do know is that a heel strike landing running style is related to most common running injuries and it’s high impact nature could perpetuate strain on the IT band. As for a forefoot strike landing, there is no association of this foot strike type and ITBS, implying to me that forefoot running is not a risk factor for ITBS.

Preventing IT Band Muscle Pain When Running

But, what if you are new to forefoot running and suffer ITBS?

Running-Related IT Band Muscle Pain Explained

IT Band Syndrome Caused by Crossover Running

One potential cause of ITBS is a crossover running style (a narrow step-width) which is influenced by weak hip abductors.

  • A crossover running gait involves a foot strike position that crosses the mid-line.

Crossover running causes the IT band to compress the fat pad located under the band. Over time, the compressive forces cause the fat pad to become inflamed, leading to pain that radiates on the outside of the knee. Crossover running can be easily corrected by strengthening the abductors.

  • How do you know if you run with a crossover? Run on sand, and check if your footprint pattern crosses over the mid-line.

If you run with knocking knees, this is also a risk factor for ITBS. When another group of hip muscles, the gluteus medius, are weak, this causes the femur to point inward (femoral rotation) during the stance phase of running, causing the knees to clip each other (i.e. knocking knees). When femoral rotation is high during the stance of running, the IT band becomes pulled and strained as well.

How to Prevent IT Band Muscle Pain When Running
Above, on the left, is how your thighs should appear during the stance phase of running. The thighs should be straight, not veering inward, and the knees kept apart. Shown on the right, is a runner at risk for IT  band syndrome as the thighs point inward increasing compressive forces by the IT band on the outer-knee.

The take home message here is that ITBS is more related to hip muscle weakness, not forefoot strike mechanics and can  be treated and prevented with appropriate strengthening exercises

  • Another point to mention is that running on slanted roads as well as the turns on a track may cause ITBS, too.

If your IT band is acting up on you, here are effective hip strengthening exercises that will give you stronger hips so you can maintain a naturally wider step while running.

I Hope this helps!

More From Run Forefoot:

Bretta Riches

Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!

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