Along with blackened toenails, many runners tend to suffer from iliotibial (IT) band syndrome—an overuse injury that often causes pain on the outside of the knee. It’s usually blamed on a tight IT band, which leads people to stretch and foam roll the wide strip of tendon on the outside of their thigh in hopes of loosening it. But that may do little good. Strengthening, not stretching, could be the best way to deal with the problem, Canadian researchers reveal.
In a small pilot study, nine people suffering from IT band syndrome underwent a 6-week rehabilitation program that focused on strengthening hip muscles like the gluteus maximus (your butt muscle) and gluteus medius (a muscle that helps raise your thigh out to the side). At the end of the study, all the runners were able to run pain-free. The length of their IT bands remained unchanged despite efforts to stretch it, but everyone’s hip strength increased.
“The IT band is like a chunk of leather, and it will never stretch,” says study author Reed Ferber, Ph.D., an associate professor at the University of Calgary and director of the Running Injury Clinic. “By foam rolling and stretching, you only minimize the symptoms.”
So what do your hips have to do with your knee pain? The gluteus maximus and gluteus medius attach to your IT band, Ferber explains. When these muscles contract, they pull on the IT band and keep your hips and knees aligned. However, if these muscles aren’t strong, your hips and knees can twist. This triggers the IT band to rub over underlying tissue and cause pain on the outside of your knee, he says.
To fix the underlying problem, you need to strengthen your hips. That’s why Ferber recommends performing these two exercises to prevent and treat IT band syndrome.
DO THIS: Do 1 set of 10 reps of each exercise on day 1. On days 2 and 3, perform two sets of each exercise. Every day after that, do three sets. Perform the exercises well before or after a run. Foam rolling the IT band is still beneficial because it reduces the symptoms, so Ferber suggests using it in combination with the strengthening exercises.