IT Band Syndrome recovery roadmap: What that awful pain on the side of your knee is, and how to fix it

If you're reading this now, you likely know that feeling of being three or four miles into what was supposed to be an easy run, legs feeling fresh, and then, BAM!, a sharp, burning ache lights up the outside of your knee.

It might ease off if you stop and walk for a bit, but the second you pick up the pace again it’s right back. Sound familiar?

That’s iliotibial band syndrome (or IT band syndrome / ITBS / it band pain) in a nutshell, and if you’re a runner it’s probably shown up in your training log more times than you’d like to admit.

I’ve been there, twice actually, once during my first ever half marathon training block, many years ago, and again the next year when I got a little too excited about back-to-back long trail runs.

The good news is that it doesn't have to be game over for your running. In fact, with the right approach most runners are back to pain-free miles in roughly 4–8 weeks.

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Alastair RunningAlastair Dixon

I’m going to walk you through exactly what’s happening, why it happens to runners like us, and the exact roadmap I used to fix it for good. No fluff, just the stuff that actually works in the real world, and no, I haven't had it since.

What Is Iliotibial Band Syndrome Anyway?

If you're going to fix ITBs, it helps to understand exactly what it is, and what causes it.

The iliotibial band (or IT band) isn’t a muscle, it’s a thick strip of fascia that runs down the outside of your thigh from your hip (specifically the tensor fasciae latae and glute max) all the way to just below your knee on the tibia.

Its job is to help stabilise your knee and hip during movement, especially when you’re running and your knee bends and straightens over and over.

IT band syndrome happens when that band gets irritated from rubbing over a bony bump on the outside of your knee (the lateral femoral epicondyle if you want to get fancy) around the 30-degree flexion point, exactly where it happens thousands of times per mile.

It’s not usually the band itself being “inflamed” in the classic sense; it’s more like compression and friction on the tissues underneath, often because your hip muscles aren’t controlling things quite right.

It accounts for roughly 12–14% of running injuries, and yeah, it hits women a bit more often (wider pelvis = more potential for that inward knee collapse). But I’ve heard of it happening in every type of runner from road, trail, ultra, beginner, and elite.

How IT Band Pain Actually Feels (The Symptoms Runners Notice)

• Sharp or burning pain right on the outside of the knee, usually 3–7 miles in.
• Pain that gets worse with downhill running, stairs, or longer efforts.
• Sometimes a clicking or snapping sensation as the band flicks over the bone.
• Can creep up into the outer hip or thigh, especially if you’ve been ignoring it.
• Usually no visible swelling (that’s one way to tell it apart from a meniscus issue).
• The pain often calms down with rest or walking, but comes roaring back the moment you try to run again.

If you’re nodding along right now… welcome to the club.

Why Do Runners Keep Getting This?

The big culprits I see (and have felt myself):

• Sudden mileage or intensity jumps — classic “too much too soon”.
• Weak glutes / hip abductors (glute medius especially) — this lets your knee cave inward and puts extra stress on the IT band.
• Running lots of downhill or cambered surfaces.
• Worn-out shoes that no longer control pronation.
• Tight hip flexors or TFL that tug on the band.
• Poor running form (overstriding, crossover gait). If this sounds like you, read my guide to running with proper form.

It’s rarely just a “tight IT band”, that’s the symptom, not the cause. The real fix is almost always upstream at the hips.

Quick Self-Check: The Ober Test (Do This at Home)

Lie on your side (affected leg on top), bottom knee bent for stability. Let the top leg hang off the edge of the bed or couch so it can drop toward the floor, simulating that inward rolling leg.

If your top leg stays up in the air instead of dropping down comfortably, or if you feel that familiar outer-knee pull… bingo.

Pro tip: get a physio or coach to check it properly if you’re unsure, better safe than six weeks sidelined.

My Step-by-Step Roadmap to IT Band Recovery

Here’s exactly what worked for me. I break it into three phases so you don’t have to guess.