The ITB Rehab Routine – Video Demonstration

by Jason Fitzgerald

The last major injury I had was a severe illiotibial band (IT Band) injury after the New York City Marathon in 2008. I took 9 days off from running after the race and then started to slowly run a little bit, only to have sharp pain on the outside of my left knee. I couldn’t run for six months.

After seeing several physical therapists and spending countless hours researching the best treatment programs, I developed the ITB Rehab Routine. This strength protocol strengthens the glutes, hips, and quadriceps and allowed me to finally resume training after six months of inactivity.

Even though my IT Band injury has fully healed, I still do this routine because I think hip strength is very important to runners.  New research shows that weak hips are to blame for lower leg injuries. More aggressive rehabilitation for IT Band injuries can be done in the gym with dead lifts and squats to strengthen the glutes, which are often weak in distance runners and the reason the IT Band can get inflamed.

Note that this routine is not a complete rehabilitation program for IT Band Syndrome. This is just one piece of the puzzle. For a step-by-step treatment protocol for ITBS, see Injury Prevention for Runners.

The ITB Rehab Routine consists of seven exercises done in a row with minimal rest. I do one set. Below is a demonstration of the exercises, using a Thera-Band. The video isn’t perfect, but it works:

  1. Lateral Leg Raises: lie on your right side with a theraband around your ankles.  Lift your left leg to about 45 degrees in a controlled manner, then lower.  I do 30 reps per side.
  2. Clam Shells: lie on your right side with your knees together and a theraband around your lower thighs.  Your thighs should be about 45 degrees from your body and your knees bent at 90 degrees.  Open your legs like a clam shell but don’t move your pelvis – the motion should not rock your torso or pelvic girdle.  Keep it slow and controlled.  I do 30 reps on each leg.
  3. Hip Thrusts: lie on your back with your weight on your upper back your feet.  Your legs will be bent at the knee.  Lift one leg so your weight is all on one leg and your back.  Lower your butt almost to the ground and thrust upward by activating your glutes.  This exercise is great for glute strength and hip stability.  I do 25 reps on each leg.
  4. Side-Steps / Shuffle: with a theraband around your ankles and knees slightly bent, take ten steps laterally.  The band should be tight enough so it provides constant resistance during all steps.  Still facing the same direction, take another 10 steps back to your starting position.  That is one set.  I like to do 5 sets.  This exercise will look like a slow-motion version of a basketball “defense” drill.
  5. Pistol Squats: These are simply one-legged squats.  The key to a successful pistol squat is to not lean forward, keep the motion slow and controlled, and make sure your knee does not collapse inward.
  6. Hip Hikes: Stand on your right foot.  With your pelvis in a neutral position, drop the left side so it is several inches below the right side of your pelvic bone.  Activate your right hip muscle and lift your left side back to its neutral position.  I do 20 reps per side.
  7. Iron Cross: This dynamic stretch will help you feel loose after the previous strength exercises. Lie on your back with your arms out to your sides and swing your right leg over your torso and up to your left hand. Repeat with your left leg and do 20 reps in total.

After my experience paying $30 to go to a physical therapist twice every week, this video is easily worth hundreds of dollars to the runner who applies it to their injury. If you use a foam roller for myofascial release after the routine, you are getting almost all of the benefits of a PT without the cost.

The only thing you need is a good Thera-Band.

A step-by-step treatment program for ITBS is also included in the Injury Prevention for Runners program.

Here are a few things to keep in mind when doing this strength routine:

  1. If you currently have ITB pain, you can do this routine as often as every other day.
  2. Always modify the number of reps or recovery period if you need to.
  3. Even if you don’t have ITBS, you can do this routine 1-2 times per week for prevention.
  4. You can do this routine in addition to running (do it when you finish).
  5. Increase reps or add weight to any exercise to increase its difficulty.
  6. If you can’t do pistol squats, here is a progression to get you there safely.
  7. Get the low/medium resistance Thera-bands at first (or a combo pack so you can progress).

If you always forget the exercises, get custom illustrations of the entire routine (free) by joining now:

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{ 191 comments }

Lisa

Whew, good to know I’m doing ‘em right. Sometimes it’s hard to picture stuff in your head. I’m looking forward to the next one!

Fitz

Exactly, that’s why I’m hoping some videos will be helpful. Stay tuned!

Adam

Hey Fitz. Appreciate the video. Good stuff. I have been using variations of this routine for some time now. I like to mix it up a bit for the simple sake of variation and multiple muscle activation (ie. use the bosa ball for hip thrusts, and curls, etc). Just a quick question for you. Notwithstanding using the routine above I have been hampered by what I suspect is a case of ITB for the last month or so. Started with mild pain at the insertion above my left knee with some swelling on the outside of the knee. It has improved but it is still seriously hampering my ability to run and seems to be very slow progress. Uphill is fine but after an hour of varying surface the pain kicks in pretty quickly above and below the knee. Just was hoping for your opinion given that you have dealt with this in the past. Does it sound ITB-like to you? If I set the grade on the hill at 7-10% and run easy I get little discomfort- but this is boring. But I wonder if I am just setting myself back each time I do this? I struggle to take days off. Your thoughts would be greatly appreciated. Got my first ulta-race of the season in late April so…. time is not on my side.

Thanks a bunch.

Fitz

Hey Adam, that definitely sounds like ITBS. Pain on the outside of the knee is ITBS the vast majority of the time. I would continue to train on hilly surfaces if that provides relief, but remember that dull/achy pain isn’t doing any more damage but sharp/intense pain will. If you feel anything sharp, stop.

Glute weakness is a major contributor to ITB pain, and for myself I found that dead lifts were a great way to combat this problem. I’m not sure what your strength training is like, but you may want to look into this. Hill sprints also helped me. Good luck on your ultra this April!

Simon

This is really timely for me. I’ve spent the past two months battling what I and my physio think is ITBS (though I suspect it’s something deeper). Whatever it is, I’m sure these exercises will assist my recovery. Many thanks!

Fitz

Glad I can help Simon, thanks for stopping by. Let me know if there’s anything else you’d like to see here on Strength Running.

Simon

Exactly the same as you have been, my friend; you have an awesome website. I’ve actually ordered some resistance bands based on seeing your videos here to boost some of the strengthening exercises I’ve started doing. I still don’t understand what my problem is – knee pain on the outside along with upper quad tightness, misc aches all over and general “dude, your left leg is not cooperating” feelings. Seeing the physio again tomorrow so hopefully she can prod her way to the truth a little. :)

Marko

Hi Simon! I was just thinking what has happened with your ITB problem at the end, because you have precisely described my problems, which none of the physio therapists I have been to, didn’t fix.
Thank you!

Lou Ann

I enjoy your site very much and follow your training on Dailymile. I am having some ITB issues as well. Pain outside left knee. I have a marathon in 4 weeks. I did my 18 miler last week. Step-down to 14 this weekend and 20 miler next weekend then the taper. I have been doing alot of crosstraining, spinning & eliptical and less running during the week. Have been doing alot of those exercises already. I’m not out to break any speed records but finish my 1st marathon. I’m hoping this plan will work. I can add deadlifts with my kettleball at home. Thanks again for sharin gthis great information. I hope to really use this after I complete my race.

Fitz

Thanks for the comment Lou Ann and sorry to hear about your ITB pain! I’d be a little weary of the elliptical because it puts a strain on the hips, but otherwise try out the ITB Rehab Routine and dead lifts definitely help strengthen weak glutes/quads (which are often a contributor to the injury). Good luck in your marathon!

Brandon

Thanks so much for the video demonstrating these exercises. I’ve been suffering from ITBS since around the start of this year (after completing my first marathon in December), and thanks in large part to these exercises (and my foam roller!), I seem to be well on my way to recovery.

Fitz

Awesome, great to hear Brandon. Glad it’s helpful.

Katie

Thank you so much for a video to tell me exactly how and what to do to keep my ITB pain away!!!!! so great to see the exercises so I know I am doing it the correct way:)

Fitz

You’re welcome! I have several other ITB articles, so I hope you check those out as well.

Katie Luedloff

I will be checking out those articles- How many times a week do you suggest doing the 7 ITB exercises?:)

Fitz

Hi Katie – if your IT Band is tight/painful, you could do the routine every other day. But if you’re healthy, I recommend 1-3 times per week for maintenance and general strength. Good luck!

Angie

The last few weeks I have had really bad IT band pain on my right knee. Even brisk walking hurts. Very depressing as I love to run. SO I really hope if I do these exersices it will help me get back into running soon.

Fitz

Hey Angie, I hope the routine helps. I also found that consistent use of a foam roller and lifting exercises like squats and dead lifts were helpful. You need to strengthen your glutes and hips! Good luck. – Jason.

Angie

Thanks Jason. Is it better to do these exersices everyday or should I do it every other day? I just want to get stronger faster.

Fitz

Angie and Carlos – if you’re currently injured, I would do this routine every other day. But if you’re not currently injured, I would do it 2-3 times per week for prevention. The other days you can do a different core/strength/mobility routine. This routine can be done after a run. Once you’re comfortable with it and it doesn’t leave you sore, you can do it as a warm-up. Enjoy!

Carlos

Hey
Just wondering if this would be a workout or a post-run type of thing… it sounds like this gives somewhat of a burn and might leave some soreness.

When / how often should you do this?

Roshni

Awesome!! Thank you so much. I have been sidelined with an ITB injury and the PTs, I have been too have not addressed any of these exercises. Hence the ITBS keeps recurring. I am very grateful for these exercises and the video highlighting the right form!!

Fitz

Hey Roshni, glad you like the routine. Some PT’s focus on the symptoms but the ITB RR addresses the most common causes of the injury, which is why it’s so effective. Good luck with it!

Luke

Thanks a lot for this routine!
I’ve had ITBS and knee pain for around 18 months now…it’s horrible!
I’ve started to do this routine and it seems to be subsiding!
How long do you think on it would take on average before I could start jogging again? Also, have you never experienced any kind of ITBS knee pain since performing these exercises? Thanks.

Fitz

Hey Luke, no problem! Glad I can help. It’s almost impossible to say when you can start running again – but go slow and gradually work your mileage up. Don’t run through any sharp pain. I get occasional ITB tightness when I’m running 80+ miles per week and doing hard workouts even when doing the routine. It helps a LOT but won’t make you Superman :) Just train smart – this will be a great addition to your strength program.

Luke

I see. It’s quite a tricky injury. It seems that no one has ever been completely 100% healed from it…at least I haven’t found any record of it. But I strongly believe mine is down to weak glutes/hamstrings as I sit at the computer all day. I continue to work on his routine and let you know how it goes! Thanks.

Cenk

Fitz,
Thanks for the IT rehab routine.

I believe I have a moderate case of a damaged IT band that flares up only when I run (about 2 miles into the run). I’m a new runner and I was building miles too quickly which I believe led me to this nasty injury. It’s strange how quickly the pain dissappears after I stop running.

I finally got my thera-bands and completed my first rehab routine yesterday. I can report that I am sore this morning but I’m on the mindset that I am on way to recovery. I’m taking off 1-2 weeks from running and focusing on doing the IT routine every other day, foam rolling, and doing easy cycling on the days when I’m not rehabbing.

Looking forward to building strength and running in the near future.

Fitz

Thanks for the comment Cenk – and you’re welcome. It worked for me and it sounds like you have a pretty good rehab schedule planned out. Good luck!

Cenk

Update: When I first injured my IT Band and started the IT Band routine I was in low spirits and had doubts that I would be able to run like I had in the past. But I committed to the routine every other day and then after 2.5 weeks of no running outdoors (I did do spinning and other core exercises) I ventured outside and started running very slowly. To my surprise I really had little pain and felt much stronger in my legs, quads, and glutes.

When I now run I pay much more attention to my gait, making sure that I’m not overstriding and keeping my cadence at the 180 level. I have even stopped running with my ipod shuffle so I can focus more on my mechanics and environment. I’m continuing the IT Band routine and I have even incorporated other exercises such as using the abductor machine, leg presses, and lunges.

Thanks Fitz for your routine. It’s made a huge difference in my running.

Fitz

Wow, that’s a great recovery story! Congrats on getting back to running again Cenk. Let me know if there’s anything else I can do to help.

Heather

Hey thanks so much for the routine. I pulled my it band 7 months at an ultimate frisbee tournament I wasn’t in shape for. Since then I can usually run without much pain but it starts to hurt later that day. I know every situation is different but what’s the minimum amount of weeks that you’d do this routine before trying to run again. And how often would you use the foam roller and how many minutes per session? Thanks for the help!

Fitz

Hi Heather – it really depends. I would do the routine once every 2-3 days with other types of core/strength work for at least 1-2 weeks. When you don’t feel any pain walking around or unusual tightness, you could try to run very easy for a few minutes. As long as you’re not really beating yourself up, you can use the foam roller every day. Keep it relatively brief or you could get sore. Good luck!

Meghan

Hi and thanks so much for this routine! I’m a runner who has been battling with this injury for almost 7 months now. I did both Graston and ART therapy for almost 4 months, but at this point my PT/chiropractor believes that there is nothing left for him to do – my ITB is loose, but it still hurts in my knee (and more recently, also in my hip and glute). My PT wants me to take the rest of the summer off from attempting to run, swim, bike, or dance, then slowly begin interval running rehabilitation in September. In the meantime, he mostly wants me to concentrate on strengthening my glutes, and prescribed most of the exercises you show here (although I’m definitely going to add some new ones after watching your video).

A couple of questions for you:

1. How important did you find stretching as opposed to strengthening? I have been doing both, but after 7 months of dealing with this, it’s starting to get really burdensome (I mostly work on stretching my hips). Did you stretch much to recover? If so, which stretches and how often did you do them?

2. Is there anything else you did to help recover? Icing, etc?

I have only attempted to run 3 times since injuring myself in early January, and each time I made it less than a mile before my ITB became inflamed. Each inflammation lasts a month or so, and then I recover and feel OK to run again, but it still hasn’t worked out. There was a period of time when I was able to do some interval sprint training, but then I hurt my shins and decided to stop (there are only so many injuries I can deal with at once!) When I attempt to run again in September, I’ll be starting very slowly with a program of 8 seconds of sprinting, then walking. Every few days I’ll increase the sprint time a bit more (and with more repetitions of sprinting and walking), until I gradually slow down to a normal running pace (this is what my PT advises). How did you begin to run again?

I have orthotics and correct shoes now (a pair of pronated shoes caused this injury), but it hasn’t solved everything. I now think glute strengthening is going to be what finally cures me. Thanks again!

Fitz

Hey Meghan – I’ll try to make this brief:

1) Strength over flexibility (fix the problem, which is 9/10 times a weakness NOT an inflexibility)
2) Flexibility work is helpful once you start running again to prevent stiffness, sore spots, trigger points, but for recovery focus on strength
3) I am not a fan of orthotics. 99.9% of people don’t need them.
4) This sprint/walk program sounds terrible. NOT recommended.
5) Glute strength helps a lot – dead lifts, squats, pistol squats are all immensely helpful.

Good luck! If you have more questions email me at support@strengthrunning.com

Brian

Been suffering from left hip and ITB problems for a while now, going to give this a go. Just tried the routine and could not do the thrust and the squat was a big struggle which highlights the weakness. For the thrust, is it OK to do a bridge without the leg raise to build up strength.

Fitz

Good luck Brian. Definitely do as much as you can, but adapt the routine to fit any weaknesses. Doing that will ensure you won’t get hurt. Cheers – Jason.

Kaushal

I am suffering from ITBS for quite sometime. I think with the exercises demonstrated by you, I ll be fit to run long distance again. Could you send me the link for Thera Band from Amazon, medium to high strength/resistance ? I found lot of options for it and did not understand the color coding etc. Please help.

Fitz

I just emailed you Kaushal :)

Claudia

Fitz, thank you so much for the video! I’ve had ITB on and off since I started running almost 4 years ago and I’ve had quite a few trips to the PT… however I finally got a foam roller a few months ago and that’s been helping quite a lot, now I’m going to start doing these exercises so ITB will be gone for good :)

Fitz

Good luck Claudia! It’s a hard injury to beat since the ITB is connective tissue and not a muscle, but you’ll get there. Let me know how I can help.

Beau

My IT Band started to bother me the last few miles of a 1/2 marathon two years ago. I’ve struggled with it since then. I am thrilled to find your video of seemly very effective exercises for ITB sufferers which I will start — working into some of them slowly, I’m certain, as I’m 67 — but otherwise in good shape. I’m also going to get a foam roller.

Fitz

Good to hear Beau! It’s a good idea to progress slowly with some of the exercises if they’re difficult for you. Be smart and I’m sure you’ll see progress. Good luck!

Amanda

I have been fighting ITBS for 2 years now, I just can’t seem to beat it. At times it is all I can do just to get through the day walking. Because it is now chronic it effects everything I do, swimming, biking, anything that bends my leg. I am going to give this a shot, it couldn’t hurt right?

Fitz

It probably won’t hurt – as long as it doesn’t hurt. If it’s painful to do any of the exercises then I would stop. Of course, I’m not a medical professional, and your case sounds severe so I would recommend seeing a physical therapist or your doctor. But you should also research the other ITBS articles here on Strength Running if you’re interested: http://strengthrunning.com/2011/01/it-band-injury/ and http://strengthrunning.com/2010/10/how-to-treat-injuries-healing-itbs-in-five-days/ come to mind. Good luck!

Brad

Fitz,

Im 2 weeks into the regiment with additional weight lifting exercises (squats/deadlift) incorporated in as well. My question is when can i test running again? Do i continue to hold off or can i try and work in a couple runs up until the pain starts each week?

Fitz

Hey Brad – I’d make sure that you’re not experiencing any pain doing the exercises, walking, or bending your leg. Once your glute, hip, ITB, and quad area feel somewhat loose, then I’d attempt a run. But stop immediately if you feel pain because at that point, you’re doing additional damage. You may also want to look into a good massage. Good luck!

Kimberly

I’m really excited to try these exercises! I noticed that there are different resistance options available for the Theraband. The link you posted is for the extra light resistance ones. I found that there are medium and heavy resistance ones too. Do you specifically recommend the extra light ones? I am not an elite runner by no means. I picked up running about a year ago. I went from running intervals (to keep shin splints at bay) to running a 5K but between 2-3 miles my left knee would start hurting really bad. I only got to run 3.2 miles a couple of times before it hurt so bad. I haven’t gone for a run in a month. I just tried today by walking briskly for 3 miles then ran for .5 miles and felt my knee hurting again. I’m pretty sad that it’s hurting sooner into my run after all that rest time! :( I have an appointment with a sports medicine doc next week and I’m hoping she can help me resolve this so I can get back to running and increasing my mileage.

Fitz

Hi Kimberly, sorry to hear about your knee. I think you should start with the light resistance bands when you first start with these exercise. When you’re ready (i.e., when they get really easy), you can progress to a higher resistance band. This pack on Amazon has 3 different types of resistance: http://amzn.to/piKAkI. I hope this routine helps your knee, good luck!

Rick

Great video and workout routine. I, too, suffered from ITBS at one point and I rehabbed it using a strengthening routine similar to this. (Hip hikes, side lifts, and lunges) It frustrates me that the common wisdom for rehabbing ITB injuries seems to be various forms of “stretching” the ITB when this is almost entirely ineffectual, running doesn’t test the limits of the ITB, ITB length is not correlated with increased incidence of injury. What *is* correlated with ITB injury is a decreasing angle between the femur and the pelvis during the landing phase, i.e., hip droop, and that is fixed by stabilizing the pelvis which involves strengthening the muscles that attach to it, the hip abductors in particular. I like how that is what you focus on and you didn’t mention stretching the ITB once. (I’m not counting the Iron Cross since that’s a dynamic and not a static stretch.)

Two quick points of emphasis I’d add:
1) When doing the clamshells and side lifts is it is important to keep the torso on the ground so the torso forms a line with the active leg when it is in the rest position. You do this correctly in the video, but don’t point out its importance. It seems everyone’s first inclination when doing this exercise is to prop their torso up on their elbow, so the torso forms an angle with the ground. This puts the hip at an angle it doesn’t see when running and risks involving the abdominal obliques in the lift rather than the gluteals.
2) Virtually all of these exercises are nonspecific to running. They involve angles and motions that don’t occur during running. So the runner really only benefits from the eccentric part of the movement. This just means it is important that the runner do the eccentric movement in a controlled fashion and not simply relax and let the leg return to the starting position on its own. Again, you do it correctly in the video, but you didn’t emphasize it so I thought I would.

Jason

Agreed – and thanks for the pointers. I should have made that more clear!

sarah

I injured my knee several years ago running in a 5K on the banked side of a road. I didn’t know what to do about it and since I don’t run much, it eventually went away. I recently decided to try a 10 miler, trained for 5 weeks (on a treadmill) and reached the point where I could run 4m and walk 1m (twice) without too much difficulty. However after 2.5 miles on the course I felt it again – a pain on the outside of my right knee. By mile 4.5 it had spread to my hip and below the knee, and I had to walk/hobble the rest of the way. :( Although the pain is not always consistent, my knee basically hurts when I walk or bend it, and sometimes I have pain in my hip as well. If, in fact, I have an ITB injury, should I wait until I have no more pain before I start your strengthening exercises?

Sarah

Jason

Hi Sarah, sounds like ITBS to me. The best move here is to limit your running but start on the strength exercises as soon as possible. If a particular exercise hurts, then don’t do it – or limit the movement – but you should try everything to make sure. Good luck! Let us know how it goes and if you have any other questions.

Emmanuel IM ONLY 15

Hi i am 15 and have been having sharp pains on and off for 3 months usually after i do sport an hour after the joint in the outer knee is also hot and hurting worst is it ITB? it also felt like it was swollen but the swelling has redused now but the pain is still there and mostly hurts when going up or down the stairs. what should i avoid? will it ever go away? and can i do any cardio in the gym to warm me up? please reply THANKS

Emmanuel IM ONLY 15

Hi i have been having sharp pains in my outer knee for 3 months when it seems like it is getting better after a week or 2 of rest and i go rugby training or gym ( A LOT OF RUNNING) it gets bad again and about an hour after a long run the outer knee joint feels hot for a while is it ITB? these pains started when i was increasing my time on theadmil by 5 mins each time i went gym (often) i am young and can’t live my life without sport. i want to know is it ITB? what should i not do? can i do any cardio in the gym to warm up? PLEASE REPLY THANKS

Jason

Sounds like ITBS to me Emmanuel. I’d talk to your parents and see if you can get to a physical therapist.

James

Jason,

First, thanks for all the information, insights, and encouragement you provide here. Quickly: I ran for approximately 7 months last year (getting up to 3-5 miles a day, 4-5 days a week) mainly to lose weight and get in shape. I was doing great – until the strange pain on the outside of my knee started eating into my ability to run. Like an idiot, instead of getting it checked out, I basically just stopped running and exercising until finally getting it diagnosed and “treated” with PT in July & August.

I say “treated” because, though my IT band went from “extremely tight” to “loose” according to therapists as a result of my PT routine of mainly stretching but some of the strength drills you demonstrate in your video, I still haven’t been able to shake the vague, low-level pressure in my IT band that I feel at rest. It never really hurts – and I have yet to resume any real exercise on it – but the stretch-heavy routine I’ve been doing for four months now only seems to temporarily remove this pressure (it’s not really pain per se). A few hours after stretching it, I’ll begin to feel it again.

Given all that, I’m interested by your opinion above that strengthening rather than stretching is more strongly correlative with recovery from ITBS – and eager to finally kick this syndrome’s ass to the extent one can. If you’ll permit a few quick questions:

1) Do you think the fact that I left my ITBS untreated for almost a year explains my longer recovery period? (Again, I’m over 4 months into a routine of daily stretching and foam-rolling w/ some strengthening and full rest)

2) You’ve emphasized the importance of strengthening in general and mentioned deadlifts, squats,etc. I have access to a gym. Would I get more bang for my buck with weights and traditional leg lifting or by banging the Thera-Band on a mat in my house? (Just curious. I’m willing to do both of course, if that’s best, but, after tons of “light” therapy exercises geared for “beginners” in PT, I’m ready to get as rigorous as possible)

3) That chronic (albeit low-level) tightness/pressure I describe – I take that to mean I still have an issue. Stretching has not alleviated that. Any experience with that or similar cases? Any thoughts on whether more time on strengthening can alleviate that feeling?

Sorry for the very long post – I’m frustrated but still hopeful. Thanks in advance for any thoughts you can share!

Jason

Thanks for writing James – and sorry to hear that you’re still having problems after all these months! Some answers to your questions: 1) Perhaps, though who really knows? I’m sure you’d have been better off treating it sooner, but there’s no real way to tell. 2) I’d say do both. 2x/week in the gym (just be careful) and 2x/week with the ITB RR. 3) Yes, my left ITB is not the same since I injured it. It still gets tight and I have to take extra care of it. You may have a similar case or, unfortunately, the only thing to make it feel 100% might be to stop running.

James

Thanks a lot, Jason, for the feedback. I’ll plan to let you know how it goes!

Rick

James,

I’ll chime in just because this is a pet peeve of mine. Stretching doesn’t help. In fact there was never a reason to believe it would. (Running, even for ITBS sufferers, doesn’t test the limits of the ITB’s range of motion.) But doctors and therapists constantly try to treat ITB with stretching. The real issue is weakness, particularly of your hip abductors but of your core muscles in general. Off soapbox now, let’s get to your questions:

1) It’s possible your tendon thickened when it was unable to heal itself. This thickening isn’t like muscle hypertrophy, it doesn’t contribute anything to the strength of the tendon. Your PT should be able to check for thickening and treat it, either with ASTYM or Grafston,. You won’t thank me for this. It’s very painful.

2) It depends on you. I’m of the opinion that compound motions are better than isolation exercises for dealing with isolated weaknesses. If you have a weak muscle in a chain there is something wrong with the entire chain that brought that weakness on in the first place. Squats, when correctly done, are an excellent exercise and will build a stronger core than you’ll ever get on a swiss ball. They take a lot of work, however, and if you’re not willing to learn how to do them correctly or shy away from heavy, hard workouts, isolation exercises are a good alternative. They are easier to do, don’t require a big investment in equipment or memberships, and I know lots of people who have overcome ITB problems using just isolation exercises. Jason’s program is excellent and I’m sure you would be successful if you follow it.

3) You can be healed. Don’t let anyone tell you otherwise. Build up your strength until your pelvis is rock stable when you run, make sure the tendon has healed properly, and you’ll lick this thing. My experience is you can get about 80% of the benefit in very short order and be back to a basically normal running routine in just a few weeks. Fixing that last 20% might drag on for the better part of a year, but it should improve constantly. If it is not making progress find out why. Your body wasn’t meant to hurt.

I’d temper Jason’s advice about stopping running by adding the words “in pain.” Stop running in pain, but run as much as you can pain free. If that’s 2 minutes on a treadmill then that’s how far you should run. If you can run longer then run longer but longer runs will fatigue your stabilizing muscles that protect your ITB. You should never run past their ability to protect your ITB, but if you stop running altogether your body will heal for the condition it finds itself in, i.e., sedentary. This can lead to randomly formed scar tissue, adhesions, and softer tendons. True, all of these problems can be fixed, but basically by undoing the incorrect healing and then doing it again right when you want to start running again.

James

Many thanks, Rick, for your very thorough response to my questions. I’ve been lifting a lot for my legs and am hoping this will pay off. Thanks again!

Carol

Hi Jason,
I recovered from a bout of ITBS a couple of years ago after increasing my mileage too fast and unfortunately, am suffering from it again. I’ve got some lateral and mid-calf pain going on, too, as well as the typical ITBS symptoms. I’m wondering if this sounds like two different issues going on, to you? At this time, I’m not running, just ordered a Theraband and will restart strength training as well as using The Stick for massage. This time, I won’t drop the strength exercises when I feel recovered. Thanks for the video and instructions!

Jason

Hi Carol – there could be a relationship between the two pains, but it’s too difficult to tell without setting you up on a high-tech treadmill for a gate analysis and physical therapist evaluation. My recommendation is to keep up with the strength exercises, work on your mobility with some flexibility exercises, and learn to love your foam roller (the Stick works too). Good luck!

Carol

Thanks for the speedy reply, Jason!

C.J.

Hello! I am a new runner and over the last few months, as I approached my first running goal of 5km, I aggravated my left IT band. Eventually it started hurting on its own, so I went to see a physiotherapist a few times. She rotated my hips (the source of the problem) and gave me some exercises to do. My leg still doesn’t feel normal yet, but my hips are in place now and I’m working on strengthening the muscles that are weak because of the hip issue. The physiotherapist said that I could try running a little bit for a short distance. I’ve stayed away from running for a month and am anxious to start up again, but is that a good idea if my IT band doesn’t feel completely healed?

Jason

Sometimes the best thing you can do is to run a little bit. If I only ran when I felt absolutely 100%, I wouldn’t be running nearly as much as I am! You may still feel some soreness or tightness, but as long as you keep doing your PT you’re in a good spot. Try the ITB Rehab Routine and use your foam roller on your glutes, hips, hamstrings, and quads to loosen the entire area. Good luck getting healthy!

Lisa

Hi Jason,
My name is Lisa and Ive just come across your utube video for the ITB routine and keen to try it!! I have spent so much money on Physio’s and podiatrists that I have run out of my private health cover and apart from now not being able to afford a session, I also dont see the value as I am still where I was 10 months ago..
I have always been a runner, love it! But noticed some horrible knee pain a year ago whilst doing a 14km fun run. I didn’t do any prep for it so no wonder really. Since then and up until now, I began getting awful heel pain and now my knees are both bad too. I also have some crazy pain in my right hip/hip flexor sort of area. I have stopped running as of two weeks ago and am only doing dead lifts and glute body weight exercises. I stretch/roll all the time to try and relieve the hip/glute pain but its pretty bad. Unfortunately I didn’t stop running when it started and pushed through,hoping it would just pass and Im thinking due to this it could take a lot longer to now get it better..?
I guess Im asking if you think all of this is relating to the ITB? Unlike other comments, my knee pain is right at the front of the patella and all around and never leaves me, is often worse when Im sitting down. Sorry for the lengthy email, its just good to know theres other runners out there with the same issue and gives me hope that I’ll be able to run again..
Hope to hear from you soon..
Lisa ; )

Jason

ITBS usually hits on the side of the knee, not in the front. You could have patella tendonitis or another type of knee injury. I don’t know for sure, but it’s very possible (and maybe likely) that all the pain is related to a particular weakness or running inefficiency. Yours definitely sounds like a very advanced case – I don’t have all the answers, but I’d stop running for awhile and get this figured out!

Lisa

OK thanks ; )

Matt

I have had ITBS in the past. It went away and came back with a vengence durring the JFK 50 in November. I finished knowing that I would have to take some time off. I took 6 weeks off and started short runs. The IT band starts to get tight at around 5 miles. My question is can I continue to do short runs as I rehab this issue? Thanks

Jason

My philosophy is that as long as there’s no sharp or stabbing pain, you’re fine and not doing any additional damage. Never run through pain, but if it’s just a mild soreness or tightness you can run. Good luck!

Heidi

Is this helpful for hip bursitis? It only really hurts when lying on it at night so far, but I can feel a very slight bit of discomfort at times since starting a biking/walking/running program 4 months ago.

Jason

That’s a tough question Heidi. I’m not very familiar with that injury – it’s probably best to talk with a physical therapist.

Christian

Jason,

Thanks for this – I’ve bookmarked it. This was the exact injury that kept me out of running for about 5 months in 2010/2011, and many of the physicians I spoke with couldn’t recommend a solution other than “stretching.” I’ll integrate this into my routine as I train for the next race!

Jason

Great, I hope it helps Christian – probably a lot more than just stretching :)

maria

Thanks for this – I need something to build up my hips and these worked well so far – only tried once but like the variety and the challenge.

David

Jason,

I decided to take up running last October 2011 and went to a 5 mile “Mud Run” with some friends. After that I felt great and even ran occasionally a mile or so at times when I felt like it. I eventually did a 5 miles run with a friend and decided I wanted to make it a normal routine to run. About 3 days after running the 5 mile run the outside of my left knee began hurting. After looking into it and talking with a couple other runners, ITBS seemed to be my condition. Since then I have been strength training at the gym, using ITB stretch routines, foam roller, and running small amounts occasionally to see if the pain is gone. I have noticed that I’m good for about 1.5 miles everytime I run. I have signed up for a 10K that is coming up at the end of this month but I’m not sure if I should try to endure the pain for last 4.5 miles or just not risk it at all. I’m curious to know what you think…. would I do permanent damage to my knee if I continue and try to run the 10K? Another Q would be when is it safe to try to run again after solely strength training? Thanks.

Jason

Hey David, congrats on starting to run! I doubt you’ll do permanent damage if you gut it out for the remaining 4.5 miles, but you could definitely make the injury worse and lengthen the recovery time you need. I’m not sure it’s worth it. I’d keep running as much as you can without pain and gradually that amount of time will get longer. Good luck!

David

Thanks for the advice. It’s encouraging to know that this pain can go away with the correct training. I just have a problem with staying off of it b/c I usually can’t sit still and then I get anxious to see if I’m progressing. I guess I just have to understand that it is going to be very gradual.

David Deese

Jason,

Last weekend was the 10K I was training for and it was a success because I was able to run the entire race (51:11). I was able to make it through w/o the knee pain while running. I’ve found that through my training it pays off to start at a very slow pace and then gradually increase pace. I’ve been training with a friend doing negative splits. Warming up before the race also seemed to help. I can say that I’m on the road to recovery and I believe soon I will be able to quicken my pace and still be pain free.

Heidi

Maybe it is in here someplace and I missed it, but can someone please give me an idea of which size and color of TheraBand to use? I have never used one but see there are various different ones available. Thanks.

Jason

Start with a low resistance band and you can move up eventually. I believe Amazon sells a 3-pack of different resistance bands.

Heidi

Thanks Jason. However, besides the resistance there are various sized loops as well – 8-inch, 12-inch, 5 feet. Am I guessing correctly that 12 inch bands would be appropriate?

Jason

I’d buy the 5 feet bands and cut it so you can make different sized loops. In the video I have a rubber tube that’s tied. Try these: http://amzn.to/zdf4Ww

J D

If your band breaks you can just super glue it.

Rebecca

I just wanted to say thank you for making and sharing this video. I’m currently on break for training for my first half marathon due to ITBS and I’ve been using this routine to hopefully get back on track. So far so good!

Julian

So you’re saying that I can replace this routine with dead lifts and squats??

Honestly that sounds a lot more up my alley. As long as it will give the same benefit….

Thanks for the tips!

Jason

I wouldn’t replace the routine, but adding dead lifts can be very helpful.

Julian

So you’re saying there’s no way to get out of doing these stretchy band exercises?? :)

Julian

Also, what type of resistance am I looking for, as far as the thera-band goes.

I know it probably varies, but if it helps, I’m a 6′ male, 180, decent shape.

Rick

Julian,

If you are talking about *replacing* Jason’s rehab routine with heavy weight training, realize you are conducting your own experiment. Much of what Jason proposes is based on or similar to studies that have been done on ITB rehab and has a lot of anecdotal experience testifying to its effectiveness. I personally rehabilitated my ITB problem many years ago using movements very similar to what Jason recommends.

That said, there is good reason to believe heavy, full-range squats *could* rehabilitate an ITB injury. While I had already resolved my ITB issues long before I started barbell training and so can’t comment on how it affects that injury specifically, I feel it has cleared up a bunch of nagging injuries that I had constantly been fighting. Recently there has been quite a bit of research into heavy lifting to improve running performance, but to my knowledge none of this research has addressed injury rehabilitation or prevention. It boils down to how enthusiastic you are about experimenting on yourself.

The keys are in the phrases “heavy,” “full range,” and “squats.” Doing dozens of reps with plastic-coated dumbells is more likely to cause a repetitive motion injury than resolve one. No way those cute little dumbells are going to mimic the forces your muscles experience during landing when you run. As for full-range, the hip abductors in particular don’t get much use in partial squats. Finally, barbell squats, not smith-machine squats, and definitely not machine leg presses or seated knee extensions are critical to strengthening the entire chain of muscles involved. Avoiding injury means stabilizing the pelvis against abnormal and wasteful (no pun intended) motions. Your pelvis is constantly in a tug-of-war between your core and your leg muscles. Isolation exercises like knee extensions strengthen the legs without strengthening the core, thus contributing to the very imbalances that cause pelvic instability.

One final note: Many runners avoid heavy lifts because they are worried about putting on weight. Weight is an important concern for endurance runners, but lifting more doesn’t add to your weight, eating more does. Exercising can alter body composition, but only eating can add mass and therefore weight. Not eating more and continuing to run while you train will definitely impact your max lifts, but since your goal is running and not maximum lifting that shouldn’t bother you. You should still be able to make progress on your lifts and avoid injury while you run. Watch for overtraining, though. You probably should cut back on the weight training during heavy endurance training and vice-versa.

Julian

Is that it?? :)

Just kidding, thank you very much for that response. I’m new to all this, and that gave me a lot to think about.

Rick

“Is that it??”

No. I forgot to mention for runners I really like power cleans.

Matt

Hi Jason, I have had what I am confident is ITBS for about 3 months now and have tried to run through it with a few breaks in hopes of fully healing it. I am on my third break right now and hope to return back to running asap as I’m currently in my last season of High-school Track. Each break hasn’t fully healed it and I felt I needed this break because it was getting really bad. Could you do these exercises everyday or do you think that is too much? Also, have you ever met someone who has run through ITBS and successfully gotten over it with strengthening exercises? I hate missing time from running but just wish this nagging injury would go away. Thanks so Much, Matt.

Jason

Hey Matt – First I’d consult your coach and trainer to see what they think you should do. The ITB Rehab Routine can be done regularly, but the most I’d advise is 3-4 times per week. You can do other types of beneficial strength work on other days. Running “through” ITBS is risky, but as long as you’re not feeling any pain you can run. Good luck!

Heidi

Here’s my question. It seems like these stretch band exercises are going to also strengthen the outside of your legs, and if you are having also runner’s knee or patellofemoral problems (which I am starting to get minor symptoms of), I read that it is from an imbalance of the inner quads being weaker than the outer quads. They had you using the stretch band from the outside (tied to something) pulling your leg in to the midline. So are the IT band exercises going to further aggravate patellofemoral syndrome unless you really work on inner leg/quad exercises as well? Hope this makes sense.

Jason

Hopefully the ITB RR isn’t the only routine you’re doing. The pistol squats will help with any imbalances, plus any other core/strength work. But usually hips are weak in most runners because we spend most of our day sitting so it’s not generally an issue. I wouldn’t worry about this level of detail.

Matt

Julian, I have one more question. When you had ITBS and started to do these every other day, how long did it take before you could return back to running pain free?

Matt

***Jason***

Jason

I’d say about 4-6 weeks, but keep in mind it was part of a larger rehab strategy including other exercises and massage.

Noel

I don’t have ITB issues, though I have very weak glutes. Would this routine help with that. I’ve already started with Jay Johnson’s Myrtle Routine. Should I do the ITB Rehab Routine in addition to the Myrtle Routine to make sure I really strengthen my glutes?

Jason

The 1-legged bridge thrusts and pistol squats for sure. Enjoy!

Melissa

Hi, I have myofascial pain syndrome in my left hip and my orthopedic dr said I could run through the pain. This routine sounds like it will help to strengthen my hips and surrounding muscles and may help with my pain. Is this also a good routine for hips or can you recommend one?

Jason

Hey Melissa – this routine will definitely strengthen the hips. That’s one of it’s main focuses as ITBS sufferers typically have weak hips. I can’t say whether or not it will help with the pain though. Good luck!

Konrad

I do martial arts on a daily basis and have been dealing with some soreness in my left leg for about a month, specially my outer thigh near my greater trochanter. Eventually the soreness progressed to a tightening, sharp pain that I feel mostly when I stretch my left leg or throw right round kick which causes me to twist my left leg around the area experiencing pain. I have also experienced tightness up into my lower back and glutes. I have been to a chiropractor and he advised me to keep stretching and use the massage foam roller, but I haven’t seen much improvement. He also told me I could stay active and I definitely opted for this because my martial arts classes are paid for in advance. We don’t run that much for our training (we’re expected to do it outside of class) and I have not experienced the knee pain that is described with most IT Band injuries. I am starting to wonder if I will need more extensive stretching/rehab or to actually rest the leg completely. I am going to implement this routine and see what happens, but any other suggestions are greatly appreciated.

Jason Fitzgerald

Stretching and rest are RARELY effective. Start with this and see my other posts on ITBS. Good luck!

Michelle

Dear Jason
I am hoping this is going to be my life saver! I started running around 2 years ago and i just love it. 3 Months ago i went for a run and started getting pain in the lower end of my knee patella, i didnt think much of it but then other issues started arrising, i began getting a dull ache from my hip down to my knee and slowly but surely the outside of my knee began seizing up, the pain was crippling, i couldnt walk down stairs at all even brisk walking on flat surfaces brought it on. I have seen chiropractors, PT’s etc, they seem to have managed to ease the pain from the Vastus Lateralis, but my ITB is still inflammed and tight and my ankle and shin often gets very tight( i assume this is now due to stress on the area from the issues higher in the leg)
I have rested completely for over a month, stretching religiously twice a day and doing self massage day and night, and foam rolling! But i only feel mildly better.

I was so excited to find your website as everything you say makes complete sense. I know i have never had strong glute or hips and i have contracted hip flexors, so strengthening the this area makes complete sense.

I started the exercises last night, and struggled to do your recommended reps, which shows how weak i am!

I have some questions though, do you recommend i continue to stretch twice a day?
Are there side effects of these exercises, will they irritate the itb?
Would you recommend swimming as a way to keep fit while doing this rehab.

Thanks for listening to my story! And thanks again for sharing this with us!!!

xM

Jason Fitzgerald

Hi Michelle – I hope it’s helpful! Answers to your questions: 1) Static stretching doesn’t really help ITBS (stick to dynamic) 2) Not that I know of 3) Sure!

Katie

Hi Jason,

I had a ITBS about a 1 1/2 did therapy and your routine religiously and haven’t had any pain in my knee. Got a little lazy about doing the routine and using my roller. I don’t have pain on outside of knee but now have pain on outside of hip on the same side. Everything I have read says that is also because of ITB being tight. 1 week ago ran a half marathon, ran it fast for me and a lot of it was downhill. No pain until after a 5 mile run two days ago. Just did your routine and have been icing and using roller. Is it ok to continue running and elipitcal? How often should I do your ITBS routine while I still feel pain? Thanks Katie :)

Jason Fitzgerald

Without knowing more I’m not sure, but general advice is you can run/do the exercises as long as you’re not in pain or making it worse. You can do the routine 2-3 times per week, with other core work spaced in too. Good luck!

Katie

I meant to write 1 1/2 years ago Sorry:)

Renee

I am a recreational runner and have been battling ITBS for a few months now. I get pain between 1-1.5 miles. Everything I have researched says “stop running.” I am going to start doing the excercises in your video: when and what kid of running should I be doing? I used to do half-marathons, but since starting a family, I am now getting 2-4 mile runs in at about an 8:15 pace. Thanks for the great website!

Jason Fitzgerald

Hi Renee. Sorry to hear about your ITBS troubles, here’s hoping you can get healthy soon. General advice is that you can run so long as you’re not feeling any pain. The idea is to gradually be able to run more while doing the exercises so you can rehabilitate the injury. Good luck!

Julian

What are your thoughts on pain AFTER runs. I’ve been an ITBS sufferer for a while now, and after lots of rehab(including doing the exercises in your video) I’m up up to 6 miles pain free! But I’ve noticed that unlike in the past where it would hurt during and subside when I stopped running, now it feels great during, but I experience soreness after, even for a few days.

Jerry

Great video! Have been having IT band for almost a year. I dont have any more runs planned for this year and I am planning on your routine + strength trainnig, however I have to do something to kill my energy and that is biking (lots of it) would that help or not? I have no pain on the bike by the way. Thanks a million again!

Jason Fitzgerald

As long as it doesn’t cause any pain, go for it.

Jerry

Fast response (literally less than 2 min).
Will do, thank you again!

Julian

Hi, did you notice my question above Jerry’s? Regarding pain after runs(not during)

Thanks,

Jason Fitzgerald

Hey Julian, sorry for missing that. I’m not entirely sure. If it’s just soreness like you say that’s not necessarily bad, but if you’re experiencing stabbing/shooting pain then you might be running too much.

Julian

It’s definitely not the “classic” IT band pain, it’s more of a soreness in that area. More of a dull lingering pain as opposed to the nasty stabbing pain that I used to get during runs.

Thanks!

Morgan

I just got the link to your video from another running blog. I am so glad I found this. I have had it band issues for yeas and went to an orthopedist that told me I was just not meant to run(ugh!). I went to a chiropractor who gave me some exercises that got me to a half marathon without pain! Now my pain creeps up around mile 9-10, I cant wait to try what you are suggesting, I’m hoping to get to 26.2 one day:) thanks!

Stacey

Thanks for the information! I battled ITBS about fifteen years ago and it was so bad I quit running completely for nearly ten years. I picked up running regularly about four years ago and have now successfully finished two marathons. I’m training for my third and my IT band flared up this week. I freaked out! I’m taking a week of from training and swimming/biking instead. I’m going to try your exercises and hope they offer some relief. My goal is a BQ marathon time in October!

Jason Fitzgerald

They’ve helped a LOT of runners Stacey so I help this routine helps you too! Good luck getting that BQ!

Kelly Collier

Thank you so much for this information. I injured my hip training for the Air Force half marathon last year. I completed it, but have not been the same ever sence! I have pain in my right hip, both IT bands and it seems as thou ever muscle in my hips and legs are always tight. I have seen many therapists and no one can loosen me up. Im so frusterated! I haven’t ran in 5 months and I hate it! I am definelty going to try your routine and I only pray that it will help cure me. I have also started swimming. DO you think its ok to swim everyday and do this routine? Swimming is the only thing that doesn’t hurt me. Also should I start working out my legs at the gym on the machines? Is that too soon?

Jason Fitzgerald

I think that as long as you’re not in pain, you can swim and do leg exercises. But check with your PT…

Tim

No kidding, I’ve been doing physical therapy for a few weeks and have seen half of these things built into my work outs there. This is a great resource. Thanks for sharing – I’ve got a couple other things to add to my regiment.

Nikki

Hello Jason,
I just completed your exercises and I am so excited to keep at it. My left IT started to bother me about a week ago. I have been resting, icing, stretching and basic hip strengthening exercises that I know. The problem is I am supposed to be running the last leg of a marathon relay this Saturday. The mileage is 5.5 miles. Do you think I should rest and not run the majority of the week or should I try to run mid week and see how it feels. I don’t really have a back up runner to fill my spot if I can’t run so I really want to try and run this. I tried to run this past Friday and it was a no go. I tried again Saturday after stretches, icing and exercises and I made it about 2 miles before it really started to bother me. I havent tried the foam roller which I will get tomorrow. Any specific thickness? Im pretty petite if that helps. What are your thoughts ? Thanks again for the routine!!

Jason Fitzgerald

When in doubt, sit it out. Doesn’t really matter the thickness of the foam roller.

Dr. Paul

Hi Jason,
Just wanted to share a recent ITB rehab success story with you and your followers. I’m a 35yr old male, 3yrs running experience, and two marathons under my belt with a 3:21 PR. The past few months I’ve been training for Berlin, doing lots of hilly runs, speed work on the track, and the other staples. On September 1st, I went out for what was supposed to be an easy 8 miles and had to cut my run short at just the 2 mile mark. My right leg was clearly suffering with major tightness in my glute/hip area and pain that seemed to radiate down my leg from my hip to my knee. I had felt some tightness earlier that week during all of my runs but just chose to run through it and ignore what I was afraid to admit could be looming: dreaded ITB syndrome. With the Berlin race less than a month away I couldn’t afford to lose time to injury, so I decided to be less of a stubborn runner and more of a realistic one. Immediately I put running on hold and started researching ways to try and rehabilitate. In the past I had done some hip exercises I learned for a previous but similar condition affecting my left leg but thought there must be more to getting better than just doing leg raises and rolling on a foam roller. After just a few short but desperate Google searches, I stumbled on your site and specifically this section on your ITB rehab routine. I watched the video and thought I might as well give this a shot. I did the routine or a variation thereof every other day that first week of serious rehab. After about 4 days of non-running, I got out for a very easy 4 miles. The next day 5 miles. Two days after that 13 miles. I still had some pain but I tried to convince myself things would get better. For 3 weeks I built my training back up and did the ITB rehab routine 3x per week. I missed out on some miles and speed work during this period but at least things were improving. By the 4th week, my pain had completely resolved and I had no indication of ever having had an injury. Yesterday, I’m ecstatic to say, that I ran Berlin almost effortlessly in 3:27 with near equal splits for each half!!! This wasn’t a PR but by far my best executed marathon. Given I was coming off an injury, I chose to run conservatively and ran according to feel as opposed to a specific time or pace. What is more relevant to you and your readers is that 29 days before Berlin, I couldn’t run without intense discomfort…nor walk without an obvious limp. Using the tips I learned on your site, a theraband, a foam roller, and some discipline I managed to rehab this injury in less than a month and run my best marathon yet!! Thanks for the great advice and needless to say, this ITB routine will become an integral part of my regular marathon training moving forward.
Cheers,
Paul

Jason Fitzgerald

Wow, what a success story! Thanks Paul – this is awesome. Nice work running Berlin!

Zak

I have been dealing with this issue on my left leg for many years now and when doing the hip thrusts on my right leg I feel the burn in my glutes like it seems I am supposed to but when I do the left leg (the one my knee hurts on) I feel nothing in my glutes and my hamstring cramps and get pretty painful…is my hamstring trying to do the work of the glutes? I have tried to focus on engaging my butt when I do the lift but I can’t stop my hamstring from seizing.

Jason Fitzgerald

Sounds like it, but I’d check with an ART specialist or PT. I can’t really diagnose specific muscle-firing problems.

Rebecca Richardson

Thanks for making this video. It is always good to get a visual of the exercises. I noticed you were wearing a Triathalon shirt. Do you have any training programs for Triathletes?

Jason Fitzgerald

Hey Rebecca – not me personally, but check out this interview with Patrick McCrann: http://strengthrunning.com/2011/05/run-your-next-personal-best-triathlon-edition/. He has a great program called “Competitive Triathlon in 10 Hours a Week”

Allison Burkholder

Wow! This is really encouraging. Is there any additional recommendation you might have for just getting your heart rate up/ achieving a cardio workout without straining on that IT band? I would like to do this routine every day but also to do some calorie burning stuff if possible. I am not a very good swimmer, though I am open to some swim options if its my only resort.

Jason Fitzgerald

Try pool running, cycling, or elliptical – as long as it doesn’t hurt you should be good.

Thomas

Will this routine help me improve the strength of my hip flexors?

Jason Fitzgerald

Yep!

Mary

Thanks so much for the video! After a year of on and off ITB problems, stretching and foam rolling hasn’t fixed the issue and I really think your strengthening regiment will really help. One multi-part question: Is it okay to be running when I begin this routine? If not, how long should I wait to start running again? If yes, should I do the exercises before, after or on a different day than running? Thanks!

Jason Fitzgerald

Lightning round answer session! Run if you can as long as there’s no pain. Do this routine after you run or 3x per week. This is all general of course, email me if you want more specifics or a customized program with other rehab work.

Julian

Great video!!

So we’ve established that running “to the pain” but stopping once it starts to hurt is a good way to continue running while recovering from ITBS. But will doing so slow recovery at all?

Would not running at all heal your IT band any quicker than running, but stopping before it hurts?

Thanks!

Jason Fitzgerald

Rest does next to nothing, so unfortunately not. Active recovery always beats passive recovery!

Jennifer

Wow, I really found this video informative and with my hip bursitis and a nice history of double ITBS (which was horribly painful) I am not taking anymore chances. I am starting these exercises immediately. I feel like I’m 90 years old! Thank you for taking the time to make this video

Jack

I have gone through some of the comments and know I will be implementing this as part of my routine, although would I do this workout on my off days from running or would it be ok if I did this on my run days either pre or post run, what would you recommend?

I am no super runner at all and am more of a beginner who would one day in my life like to go for a marathon but I know I am not a huge fan of the weight room as well, would this workout also make up for some of what I am missing out for in the weight room or should I just buck up and hit it harder?

Thanks so much!

Jason Fitzgerald

Do it post-run a few times per week, on a run day or off. This is more runner-specific, but 1-2 weekly gym sessions can also be scheduled. Good luck!

Kristin

Hey, thank you for posting this video and demonstrating these great exercises! I am going to start doing them on Tuesday (did the myrtl hip exercise routine today that someone else recommended for ITBS rehab, so i want to rest my hips a day before trying this). You seem so helpful in responding to people, so I was wondering if you had any advice for me:

I’ve been running regularly 3 days per week since August. Followed Hal Higdon’s Novicen5K program, ran 2 5K races, then followed Hal Higdon’s Novice 10K program and ran a 10K race in December. The training program goes up to only 10.5 miles per week and increased gradually, so I don’t think I was adding too many miles too quickly. I signed up for another 10K, but a few runs after my first 10K, I began getting pain on the outside of my left knee. This was right after Christmas. It continued after my run for the next 2 days during anytime I walked fast, or went up or down stairs. I took 4 days off running until the pain was gone during stairs. I tried to run but a mile and a half in I had to stop with excruciating pain that again continued for a few days after the run. I took a week off, then tried running again. Same result. Currently I’ve had 2 weeks off of running completely. I just started going back to cardio at the gym with elliptical and cycling. Ive been taking a yoga class once per week. I got a foam roller and use it twice per day. I’ve been icing my knee before bed at night. I just started doing hip strengthening exercises (myrtl routine) and am going to start doing your routine. Any other advice? When do you think it is safe to try a run again? I don’t want to run again too soon and end up sidelined for a long time. I had to drop out of my 10K, and really want to be able to train for a March 3rd 5K and not lose any more money! Thanks!!!!!!!!!

Jason Fitzgerald

Kristin – shoot me an email and let’s chat.

Kristin

Thanks. Will do…. As soon as I can find your email address….where is it listed on the site?

jtp

Hi Jason,
Thanks for the video and the tips. They’re very helpful!

I think I’m in somewhat of the same boat as Kristin above. So I’m starting to ramp up my miles in preparation for a marathon. Every time I go north of 8 miles at any sort of pace, my knee aches for a few days. Do you think I can do these exercises simultaneously with my training, or do I need to just quit the longer runs until I can strengthen the hips?

Email you directly? :)

-jtp

Jason Fitzgerald

Yes you can do this during training. Don’t run through sharp pain, but otherwise you can keep running as much as possible.

jtp

Thanks for that quick reply Jason….yeah, it’s more of a throbbing pain around the knee, not so sharp….so I’m going to be really diligent about these exercises, try to keep the runs flat and go from there. Your routine is more comprehensive than the one my physical therapist recommended, which was essentially just clam shells. Really appreciate the insights and tips!

Ravi

Thanks a lot Jason! I had ITB whenever i try to run more than 10K. I tried everything and almost gave up. But after doing your exercise routine, i can run full marathons now without pain. Can’t thank you enough!

Pedro Ferreira

Hi Mr. Jason Fitzgerald,
Firs thank you for all the information that you so nice provide to all us.
I was preparing a half marathon, but a week a go, I was diagnosed with a ITB syndrome. Since then, I stopped running and started the ITB rehab routine and cryotherapy as well.
Know I’m preparing to run again and the plan I’m thinking to adopt is:
1. ITB Routine; 2. Run (half marathon plan); 3. Stretch – 3x week
What you think? :)
Sorry, my English, best regards from Portugal.
Pedro

Jason Fitzgerald

Pedro – email me and let’s chat.

Donna F

I’ve been fighting IT band syndrome for nearly 1 1/2 years and stumbled across your site. Can’t wait to try your routine. Can you mention what your ab workout is like?

Jason Fitzgerald
Jamie

Hi Jason,
I’ve had ITBS for awhile and I am so grateful that I found your site. The video is extremely helpful. Besides the ITB RR and Core exercises what other exercises would you suggest to get my legs strong again?

Jason Fitzgerald

Hi Jamie – it kind of depends on the severity of your injury. Feel free to email me (support @ strength running . com) and we can chat.

Jamie

Hi Jason,
The pistol squats are very difficulty for me, I’m weak and my balance is not good. Should I do two legged squats for a few weeks to gain strength or should I try to do pistolsquats and lean on something?

Thanks!

Noel

Nice website. I hope this routine will fix my problem. I just started running last January, it really is a good hobby but after 2-3 weeks of running. I started to feel pain on the side of my knee. That have to do with my shoes. I changed my shoes to cushioning type because I learned that I’m a heel pronation. I will be having half marathon this March and worried because I cannot train well because of the pain after running easy 3 mile. Please tell me what to do. I tried performing like in your demo but how many times would I do it in a week. Is it advisable to do it everyday? My current training plan is Monday-Restday, Tuesday-easy-4 to 5 mile, Wenesday-Leg strengthening and Foam Rolling, Thursday-7 mile with tempo, Friday-Foam rolling, Sat-Restday, Sunday-Long Run 9-13 miles.
Thanks

Stephanie

Hi Jason,

I’m 26, primarily a dancer, but was running one day awhile ago when I started feeling a sharp pain in the back outside corner of my right leg. I left it alone for awhile and tried to stretch and just stopped running. I’m back in workouts because of an upcoming audition and am noticing the same pain. It seems like it starts at the knee and shoots up the back of my leg to my glute. I especially noticed it tonight when I went to do a high kick with my right leg and immediately had to stop with the pain running from my knee to glute. Could this be my IT band? If so, I assume I should start doing hip strengthening exercises. Do you have an estimated time as to when you start feeling some relief? I’m getting extremely nervous with auditions coming up in almost 3 wks that I won’t be able to perform. Help! Appreciate any advice!!

Jason Fitzgerald

It could be, though it’s hard to tell. Recovery time depends on if it’s actually ITBS, severity, and if you rehab correctly. Good luck!

wende

How long after starting your program do you suggest one start to run again? I have been off running for two weeks now and before your program could not walk with out pain, I am currently walking pain free.

Neil Tempest

Hi Jason,

I’ve just come across your rehab video and I really hope it’s going to work! Was training for my 1st marathon when i had to pull out due to IT Band tendonitus. It killed me to pull out but I couldn’t continue training through the pain!!! Training was going so well and thought a 3 hr time was well within my limits. Anyway had 10 weeks off running and did lots of cross training / stretching to maintain fitness. Started to do a few small runs on the treadmill and things were starting to look up. Then attempted my 1st road run after months and after 25 mins my leg was in absolute agony. Safe to say I feel I’m back to square one. So desperate to start training again so I’m praying these daily exercises will work. I’m only 26, far too young to be having all these problems :( I want to do many more events an I fear ill have to retire before I’ve even begun!

Sarah

Hi Fitz, thank you so much for sharing this. Has given me hope after not being able to run from ITB injury.
I just wanted to ask if you recommend icing the area after doing this routine and then using the roller, or if icing would just delay the healing process?

Thanks again,
Sarah

Frankie

I really enjoyed reading this fantastic info. I’ve been a runner for over 7 years but just recently completed my first Diva Half Marathon. I rested several days afterwards and then did a slow paced 3 mile run so that my muscles would stay loose and seem to have pulled a muscle in my upper right rear thigh/glute area. I was told hamstring injury by one and IT band injury by another. This is my very first running injury ever so I did some self help research. I rested from running for 10 days (just walked some) and alternated between ice and heat, massage therapy, stretches and Epsom Salt hot bath soaks. I was doing great until I did a 5K race which was my first time running after the injury and re-injured it just this past Friday. I am to do another half marathon on June 1, 2013. Do you have any suggestions to what it may be and if I am safe to begin your rehab video? How soon should I resume running? Any help will be greatly appreciated! Thank you!

Christopher

Hi Jason, thank you very much for sharing this awesome video. It really helps to visualise the exercises and I have recently purchased a few of the resistant tubing bands to do some of these exercises regularly.

I have been battling with ITBS in my right knee for just over a year. I ran with ITBS pain last month and tried to battle the pain by excessively raising my knee. This put an extra load on my front/lateral lower leg muscles to pull my foot/toes forward in the leg swing. Now I have front/lateral lower leg pain. Continuing the ITBS routine and hoping it helps both the ITBS and the mystery lower leg pain.

You referenced a video to assist in a progression to the pistol squats. The man in the video mentions that the pistol is good to correct strength/stability differences between the leg. My regularly injured leg is my weaker leg. With this information should I perform more reps (in the ITBS routing) on my right (prone to ITBS injury) leg to strengthen it up relative to my stronger leg?

Love the website and the wealth of info. Keep it up Jason.

Cheers,
Christopher

Jason Fitzgerald

You can do 10-20% more on the weaker leg – just be careful you don’t reverse the problem!

Christopher

Thanks Jason. I bought a small hard spiky ball for massaging the glutes (hard to massage with the foam roller). Do you have any articles or tips for massaging the glutes with a ball?

Shelby

Hi Jason, thanks for the video, good stuff! I am currently suffering from very sharp, acute pain localized in my outer knee and it seems to shoot down the lower side of my leg towards my ankle, I have had pain in my hips before from what was diagnosed as ITBS last summer, but had no pain in my lower legs. Could this outer knee and lower leg pain by ITBS? Also, would seeing a massage therapist be beneficial in your personal opinion? I am not running marathons quite yet, but it is a goal of mine, I am currently running much less than that and have my first 10km 10 days from now. So I am wondering if massage therapy will aid in a speedy recovery, and if I should stop running altogether until the pain subsides? Regardless I will be trying these stretches! Thanks again!!

Rick

I’ll weigh in: No on the massage. Even the most aggressive massage therapist I have found can’t match the results I can get with a simple foam roll. Even then, I don’t think your average foam roll has what it takes to free up a damaged ITB. The ITB is an incredibly strong structure. It’s job is to catch your entire body weight when you jump or run.

The only manipulation I recommend for the ITB is ASTYM. I’ve had great success with ASTYM personally and I recommend it to anyone who has spent more than a month trying to correct their ITB problem on their own. The manipulation is very aggressive (some might say excruciating, others would say that is an understatement) but there is just no arguing with results. In my case, after months of self treatment my knee would still seize up right from the very first step. After just one ASTYM treatment I was able to run around my therapist’s parking lot without pain and within months I ran my first marathon.

Not everyone needs ASTYM to rehabilitate their ITB problem, but if you are considering adding any kind of manipulation to your treatment plan, or if you’ve tried for over a month on your own and aren’t getting results, skip massage. ASTYM is the only way to go.

You can find a local ASTYM provider at http://astym.com.

Disclosure: Not affiliated with ASTYM in any way other than as a very satisfied customer.

Matthew

Hi I have never had any pain with my it band and I do not run very often. When I do run it does not bother me at all. The main problem I have is when I do squats it clicks and is very uncomfortable and seems unsafe. It does this even with a body weight squat. I do mot squat because of it. It also does it with lunges and dead lifts but not much discomfort so i do these exercises. The physical therapist told me it was a flexibility problem and only told me one stretch. I do dead lifts which I am not very strong at. I am just starting the rehab program. Do you suggest any stretches to go along with the program? Or any helpful advice. Thanks

Maggie

I’m in physical therapy for my ITB band and doing most of these exercises!!! SO helpful and nice of you to share your expertise!

Thank you so much! :)

Mark Ruttenberg

I’m struggling with an IT band issue. I can use the elliptical and bike without issues. I have a marathon to do in October…will a daily elliptical (5-6 miles) a day with a longer workout once a week going to keep me “in shape” or should I do biking instead of elliptical. I thought I was doing fine but had my ITB pop again. I’ve been doing exercises similar to your suggested ones (switching to yours now), but am afraid I won’t be able to be ready for the October race. I qualified for and plan on going to Boston in 2014 and decided to pick up one more marathon before that. Now I’m wavering as to whether I can do the Oct. race or not. I’ve never been hurt like this before so this is new territory for me.

Jason Fitzgerald

Sorry Mark, I don’t think you’ll be ready for 26.2 miles in October with that program. Email me if you want to discuss.

Mark Ruttenberg

I was planning on participating by running the distance but not for any special time. My hip is what is hurting, not my knee. My normal program for all my marathons was to run 5-6 a day (taking one day off prior to my long run) with long runs starting at 10 and building up each week with 3 more miles added to my long one until I get to 24 then back down in 3 mile increments and it worked well for me in the marathons I have done. I was hoping to get out running by around the end of August to begin my longer runs on the weekends. I plan on continuing your routine throughout my recovery. What is your take on my plans…

Matt

Thanks for this post!
Given that I really need to build these muscles (I’ve spent most of the past 10 years sitting at a desk), should I do enough reps such that my muscles are sore the next day, or should I stick with a small amount so I can do the routine more frequently?

Michael

Hi, I have had itbs for ten years now, looking at your exercises, i’m thinking if they don’t work, nothing will. How often do you recommend doing them? And how long do you think it would take before I should start running again? I’ve also had orthoses made up, and seem to help keep the foot straighter when the foot strikes the ground but still get this pain on the side of the knee. Also, do you recommend using the foam roller to stretch the I.T band? I’ve heard from some people that the I.T band is pretty much unstretchable sp might be a waste of time.

Thanks

Janel

Hi Jason and thanks for this program.

Yesterday, I experienced severe pain on the outside of my right knee during my intervals (at 100%) to the point that I couldn’t complete the last series. The last km home (easy pace) was fine (no pain), but then I could feel pain every time I went down the stairs at my house.

I’ve decided no running for at least a few days – I’ve learned that one the hard way before, so it will only be cycling or swimming if they are pain free. I started the Rehab Routine yesterday and my knee feels better already today and no pain going down my stairs. And I’ve ordered a foam roller. Keeping my fingers crossed.

Hudson

Jason,

I have been running pretty consistently this summer building mileage safely. I just recently had a little it band pain, on the outside of my leg. It hurt to drive my knee upwards. I ran the next day 6 miles and didn’t have a problem at all. My next run ended up being 6 miles again. I had the pain, although much less intense, within the first two miles, but it faded away as quick as it came and didn’t hurt much more. I ran today 2 miles just easy and had no pain at all. My question is should I just start doing this routine, and foam rolling as much as possible, and expect it to go away? also, is there any advantage to do strength exercises with weights instead of just body weight? or should it all just be bodyweight? Thanks!

Jason Fitzgerald

It’s a first step but not a complete rehab program. Yes weights have advantages!

Mandi

Hi Jason,
I just ordered a thera-band (blue-medium/heavy resistance) online. I just got it in the mail, Its a very long band. I was wondering how small of a loop you tie it in to do this routine?

Thanks!!

Susan

Love this routine! I’ve been battling IT band pain since mid-June when training for a full marathon and increased my mileage too much too fast. Boy am I regretting that now. Didn’t end up doing the marathon, and just hoping I can get my mileage back up (pain free) to half marathon by next summer with this routine, foam rolling, and trying out yoga. And I’ve got to force myself to go slow and keep the runs short even if I feel great. Once I hit 6-8 miles, I start feeling the discomfort again, and it turns into pain if I push it too much after that. Question though — I have been really inconsistent with strength training (weights, squats, etc). Should I do strength training in conjunction with the IT band rehab routine, or do the routine for a while first? I just started your routine this week. Thanks for all the great info!

Mark Ruttenberg

Took your advice and cut my goal to doing only the half in October as opposed to the full. Been doing your exercise routine 3-4 days a week for a while and am now run just about every day. Did 7 with no problem a couple of days ago, then 4 and 4, although admittedly at a slower pace than “normal”. Thanks for the “cut” back advice and the exercises that have done the job thus far. I’m doing your work out after running (later in the day) is that the best plan or should I do the exercises right after finishing my run? I’ve also added leg lifts with 5 lb weights on my thighs. Is it smart to continue that along with your routine?

Jessica

Hi Jason,
I was just wondering whether you were icing your injury at the same time. I constantly (for about 3 years now) and brought down with it band, not just in the knee but in the hip, which means I spend a lot of time out of running. More importantly, aside from swimming, is there any cardio which you recommend? Cycling for example. I will be doing these exercises as well, there’s only so much a physio can do!

Jason Fitzgerald

No I wasn’t icing – it doesn’t do much. And yes I cycled too.

Ben

Great Video!
I’ve been expriencing a knee that I can’t say for sure is ITBS because it seems to be located on the outer side of the knee with spillage to under the knee cap (although, on the outer-side under the knee cap)
Best described in this sketch: http://goo.gl/pizbBJ
Anyway, I’m looking for a routine that is all-around a best combination to make be a bullet-proof runner. Yours seems to be a serious candidate for that.
Could you explain how to complement this exercise so It is complete for a runner?

Thanks again for this.

Kristina

I’m in the third week of training for a marathon in January. I’ve been dealing with issues in my left ITB off and on since running a half marathon in July. I reduced my mileage after that race and have been icing the side of my knee and using the Stick on the ITB/hip area after and between runs. It’s hit or miss. Usually, I can run 3-5 miles with no problems, but occasionally I’m forced to cut short a 5 or 6- mile run because of pain on the side of the left knee. If I do these exercises during marathon training, will it help or is it too late? My long run increases to 8 miles next weekend, and I’m not sure I’ll make it.

Jamie

Hi Jason. Thanks so much for this article and others. Quick question. You say to do the exercises every other day if you’ve recently had pain/tightness. I’m less than 3 weeks out from a marathon so trying to do everything I can to get prevent a recurrence of the IT band pain I had during my 20 miler last Sunday. That said, would there be any extra benefit (or the opposite) if I were to do these exercises every day? That’s what I’ve been doing the last 4 days and I feel a lot better but it’s hard to tell if there’s any real progress with the injury since the times I’ve had pain it’s been toward the end of long runs.

I’m also planning on taping with KT tape during the marathon. Any opinion on that strategy?

Thanks!

Jeremiah

I’m in the same position as Jamie. I have a marathon in 9 days. Will doing these exercises everyday help in such a short time frame?

Thanks for all of your help!

Danica

Thanks for this great video. My ITB has just started flaring up in the last week or two, but the NY Marathon is coming up in 2 weeks!–Any suggestions for last minute rehab?? It seems too late to start on the strengthening exercises at this point?

Chris

Hi Jason,
I’m training for my second half-marathon and it’s 3 weeks from race day. I started feeling IT band pain at my right knee about a week ago during a light 3 mile run. (I think the cause is I pushed too hard on the 10 mile long run the week before that.). I understood the pain and stopped running. After that, I rested two days and the pain returned after a half mile, and I stopped again. This past weekend I ran a 10K through the pain, which was only mild but hurt the most running down hill. The rest of the day I could barely walk, but 24 hrs later I can walk with little to no pain. The root cause for my ITBS is likely that I did little to no strength training for my hip abductors. I now realize I need to include strength training as a supplement to my running. With 3 weeks to go to the half marathon, should I forgo ALL running and focus on strength + cross-train (alternate daily)? Or should I reattempt some runs (~5 milers) after 2 weeks? Am I at risk of detraining too much over the 3 weeks?

Thanks
Chris

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