The Truth About How to Relieve IT Band Pain (It's Not Just Foam Rolling!)

If you've been dealing with hip or knee pain from running, you may have been told that your IT band is the culprit. But what if the IT band isn’t actually the main issue? Understanding how to relieve IT band pain goes beyond just foam rolling or stretching—it requires addressing the root causes that contribute to the discomfort. In this post, we'll dive deeper into the real reason your IT band might be acting up and explore how strengthening your glutes, improving your posture, and adjusting your movement patterns can provide lasting relief. Keep reading to learn how to relieve IT band pain more effectively and stop blaming the wrong muscle!

How to Relieve IT Band Pain: Misconceptions

What’s the first thing you are told to do if you are “struggling with IT Band stuff?”

Right! Stretch or foam roll.

While stretching or foam rolling isn't necessarily bad, neither is going to do a whole lot for long-term relief because they aren’t getting to the root cause. Read that as: they can be helpful for temporary relief and be a part of the solution, but they are not the whole solution. 

One key thing to understand is that foam rolling probably isn't doing what you think it is doing. It's not breaking up the fascia. It's not actually even relaxing the muscle specifically. It's providing a stimulus to your nervous system that can often result in a temporary downregulation, when the cells decrease their response to a stimulus making them less sensitive to that particular pain signal, or activation of muscles. It’s just a sensory input (stretching works in a similar way too).

That means yes, it can work to “relax” the muscles, but it’s only useful if you follow it up with something that can make long term changes. For example, foam roll your Tensor Fascia Latae (TFL; hip flexor muscle that feeds into your IT Band) then follow it up with some glute strengthening.

How to Relieve IT Band Pain with the TFL

Why TFL instead of the IT Band? The IT Band is not a muscle. Foam rolling it directly does not have the same downregulation from the sensory input. The IT band itself does have a lot of nerve endings, which is why it’s so painful to roll on but that doesn’t mean it’s helping! Foam roll your TFL and your Vastus Lateralis (VL; quad on the outside of the leg), but not the IT Band itself.

Then follow it up with some clamshells and donkey kicks…

… wellll…..not quite…

But, Alison, you said glute strengthening?? Yes, but to understand how to relieve IT band pain, and why these exercises wouldn’t be where I would suggest starting, we have to look a little bit deeper.

At the root of it, IT Band issues are a strength and stability issue. Ultimately, it's about your ability to load efficiently through the stance phase of your gait.

The IT band gets blamed for so much that is really not its fault at all. It is influenced by the available range of motion at your hips, position of the pelvis, and the activity of the TFL and other muscles around the knee. Those things that influence the IT Band are actually what are resulting in your symptoms. 

So, when it comes to the glute strengthening piece, it’s a little deeper than clamshells and donkey kicks. We need to address position, range of motion and integration with the kinetic chain with a heavy dose of patience and strategy to build strength and endurance through those movements progressively overloading over time. 

The Foundational Premises of How to Relieve IT Band Pain

Foundational Premise 1: IT Band issues are really strength/stability issues as we load into the stance phase of running.

Foundational Premise 2: To be able to load into mid-stance, we need to be able to internally rotate and organize our center of mass over our stance leg.

Mid-stance is where we put the most force into the ground and where the ground is going to put the most force into us. Doing this part really well is incredibly helpful in your stride!

Foundational Premise 3: To be able to internally rotate and organize your center of mass over your stance leg, you have to be able to load through length in your glutes.

This length is not the same as stretching. It's an eccentric loading as the muscle is lengthening. This eccentric loading, a type of exercise that involves forcing a muscle to lengthen while under load, is controlling the motion and stabilizing your pelvis, helping you store energy to use to propel you forward. Again, this is how we put the force into the ground and manage the forces the ground is putting into us.

In a body that struggles to find that length for true internal rotation, the TFL, that hip flexor muscle that leads and feeds into the IT band, is going to act as a secondary internal rotator.

This often will pull the pelvis into more of an anterior tilt overall. When the pelvis is in more of an anterior tilt, where the pelvis rotates forward and causes an overarching of the back, muscles like the TFL gain leverage as internal rotators. We don't have that length, so the TFL kicks on a little bit more to create that internal rotation, which pulls you into a little bit more of an anterior tilt, which makes the TFL more likely to act as your internal rotator. It’s a vicious cycle!

Also, when in more of an anterior orientation, other muscles like the VL, the part of the quad more on the outside of the knee, also gain leverage as internal rotators. 

It's not the fault of the IT band. It's a result of an overcompensation in the movement needed to get into mid stance.

Some helpful definitions:

Compensatory movement: it gets the job done, but it's not the “best” way of doing it.

Non-compensatory movement: a more efficient/balanced way of getting the job done.

Your body is smart. It's gonna find a way to get the job done. It's going to find a way to put force into the ground. It's going to find a way to move you forward as you run. Your IT Band is just an innocent bystander caught up in the mix.

Strengthen Your Glutes: Exercises to Relieve IT Band Pain

The way I see strengthening your glutes in this context is by giving the body better options to get that job done.

Step 1 in that plan is to find that length in the glutes (and the posterior pelvic floor) to help you load more efficiently into mid-stance.

That length is the opposite of what you are doing with the clamshells and donkey kicks. Just think about what those do. They're squeezing and shortening the back side (more external rotation) as you rotate that knee out, or leg up and back.

It's not that external rotation is bad. We need that, too, but we want our glute meds (the muscles on the side of the hips that help support the hips and pelvis) to be working in our stride. We just need to learn to find that length first.

And it doesn't need to be lots of low-level drills like that! Sure, we can start with some simple drills to help, but then we need to progress that to integrate directly with our main strength work (think hinging and deadlifts). Ultimately, it's about using those types of drills to gain awareness and control through finding those positions and through those ranges of motion. From there, it’s about paying attention to the position of the joints and choosing the right movement patterns WITH your strength training, not on top of it. It doesn't have to be a whole bunch of extra drills that you're doing on top of it once you sort of learn it and get the feel.

Click here to learn how to integrate this concept into your strength training.

We start with some drills and foundational movements to help find that length. But once we find that length, we need to talk about integration and even move through those ranges dynamically!

In Conclusion…

The IT band is getting blamed for a lot that's not its fault at all.  IT band issues from running, at the root, are a strength and stability issue. Stretching and foam rolling are not going to fix that.

Keep doing it if it feels good right now BUT follow it up with some strength work that actually improves your ability to load efficiently through mid-stance.

The first step is to learn to load through length in your glutes and back of your pelvic floor.

Then, we put the pieces together- your glutes, your abs, your feet- to organize your center of mass over your stance leg. Finally, we build strength in those movements over time.

Next on Your Reading List:

- Running: Hip Drop Exercise That Actually Works

- Ribs, Feet and Pelvic Floor: How to Understand Running Mechanics and Boost your Performance

 - How To Deadlift Correctly & Why "Hinging" is Important For Runners