Cause of IT Band Pain in Runners

The main cause of IT band pain in runners is a compressed fat pad from crossover running (running with a very narrow step-width). The good news is, if you are not a forefoot runner, switching to forefoot running will help widen your step width, providing relief on the fat pad that lies beneath the IT band.

The Cause of IT Band Pain in Runners

Another factor that causes ITBS is high knee abduction moments which is higher in heel strike runners than forefoot runners.

ITBS is the main cause of lateral knee pain (pain radiating at the top-outer side of the knee).

The Cause of IT Band Pain in RunnersWhat is the role of the IT band in running?

The IT band helps stabilize the outside of the knee and controls the inward motion of the thighs. Therefore, a strong IT band prevents a crossover running gait as well as unnecessary side-to-side motions.

The IT band is an extremely tough fascia that runs along the outside of the leg: put it this way, it’s as durable as a car tire.

If the IT band is so strong, why is it problematic for so many runners?

It’s not the band that is the problem; ts the fat pad located underneath the band that gets compressed due to flawed lower leg mechanics.

ITBS Due to Inflamed Fat Pad

  • if the tibia rotates too far inwardly during the stance phase of running, the IT band compresses the fat pad preventing blood flow from passing through it
  • the IT band compresses both the fat pad and the peripheral nerves in the area when a runner runs with a narrow step-width, or a crossover gait
  • biomechanical risk factors allow for this compression and ultimately, ITBS

Further, soft-tissue massage therapy and stretching exercises are treatment for ITBS but, provide temporary relief.

The cause of ITBS needs to be treated, not the symptoms. This is why it’s important to understand how ITBS occurs in the first place.

As mentioned above, one of the causes of ITBS is high knee abduction moments, which pertains more to heel strike running. Below shows how forefoot running may prevent and effectively treat the painful condition by altering knee abduction:

More From Run Forefoot:

Barefoot Running Benefits

Minimalist Running Shoe Reviews

Why Barefoot Running May Hurt at First

How to Protect Your Back From Running

How to Increase Running Endurance


Falvey et al. Iliotibial band syndrome: an examination of the evidence behind a number of treatment options. Scand J Med Sci Sports, 2010; 20(4):580-7.

Glodzick, P. Injury spotlight: Iliotibial band syndrome. Running & Fit News, 2009; 27(1): 16.

Meardon et al. Step width alters iliotibial band strain during running. Sports Biomech, 2012; 11(4):464-72.

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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