Iliotibial (IT) Band Tendonitis of the Hip Treatment

Overview

Iliotibial band (IT) tendonitis, also known as iliotibial band (IT) syndrome, is an overuse injury marked by irritation and inflammation of the iliotibial band, a thick strip of connective tissue running along the outer thigh. This band extends from the hip down to the knee, linking the gluteal and hip muscles to the upper part of the shin bone. 

The IT band stabilizes the knee and supports smooth leg movement during walking, running, or cycling. When it becomes tight or inflamed, it causes pain and discomfort along the outer knee or thigh. This condition is especially common among runners, cyclists, and individuals frequently engaging in repetitive lower-body movements.

What causes Iliotibial (IT) Band Tendonitis of the Hip?

Iliotibial (IT) band tendonitis is a non-traumatic injury typically caused by repetitive stress and overuse. It commonly affects runners and athletes whose IT band becomes tight, strained, or inflamed from repeated friction over the hip bone. Over time, this irritation leads to pain and restricted mobility if not managed properly.

• How the Injury Occurs: The IT band moves back and forth over the hip and knee joints during movement. When it becomes tight, this motion creates friction and irritation against the bone, resulting in inflammation and pain. Over time, repeated strain without rest or stretching worsens the condition.
• Common Everyday Causes: IT band tendonitis can also affect people with physically demanding jobs or repetitive movement patterns, such as warehouse workers, dancers, construction workers, and even office professionals who sit for prolonged hours without proper posture or stretching.

Common Causes of IT Band Tendonitis:

• Overtraining: Excessive running or sudden increases in workout intensity can overload the IT band, leading to inflammation.
• Running on One Course: Consistently running on the same side of a sloped road causes uneven stress on the legs, tightening the outer thigh.
• Worn-Out Footwear: Old or unsupportive shoes fail to absorb shock properly, increasing strain on the hip and knee joints.
• Improper Foot Mechanics: Flat feet, overpronation, or poor gait alignment can alter leg movement, creating extra tension on the IT band.
• Insufficient Stretching: Neglecting flexibility exercises prevents proper muscle recovery and contributes to hip and thigh stiffness.

If left untreated, this overuse injury can lead to persistent pain in the outer hip and reduced mobility.

Iliotibial (IT) Band Tendonitis Is Common In:

• Long-distance or marathon running: Continuous repetitive motion and extended mileage increase the risk of IT band irritation.
• Soccer: Quick direction changes and kicking repeatedly engage the outer hip muscles.
• Tennis: Sudden lateral movements and sprints can tighten the IT band over time.

Symptoms

Iliotibial (IT) band tendonitis often develops gradually, and its symptoms can range from mild discomfort to persistent pain that interferes with daily movement. You may be experiencing IT band tendonitis if you notice one or more of the following:

• Pain or tenderness on the outer side of the hip: This discomfort often radiates along the IT band and may feel sharp or aching, especially during physical activity.
• Pain when lying on the affected hip: Pressure on the irritated area while sleeping or resting can worsen soreness and disrupt sleep.
• Increased pain when climbing or descending stairs: Movements that involve repeated bending and straightening of the hip or knee can aggravate inflammation and friction in the IT band.

The pain may sometimes extend down the outer thigh toward the knee or worsen after prolonged sitting or standing. These symptoms are hallmark signs of hip-related IT band syndrome and should not be ignored, as early treatment can prevent chronic pain and mobility issues.

Non-operative treatment

Iliotibial (IT) band tendonitis is typically managed with conservative, non-surgical methods to reduce pain, improve flexibility, and prevent recurrence. Early intervention and consistent care are key to a full recovery.

Common Treatments Include:

• Rest: Limiting high-impact or repetitive activities allows inflammation to subside and prevents further irritation.
• IT band stretches: Regular stretching helps release tension in the IT band and surrounding muscles, improving flexibility and mobility. This is one of the most essential steps in recovery.
• Non-steroidal anti-inflammatory medications (NSAIDs): Over-the-counter options like ibuprofen can help reduce lateral knee pain and swelling associated with inflammation.

Because improper training habits or poor foot mechanics often contribute to IT band tendonitis, your doctor may also recommend preventive measures such as:

• Correcting training errors: Adjusting running form, surface selection, or workout intensity can reduce strain on the IT band.
• Choosing appropriate footwear: Wearing supportive shoes that promote proper foot alignment helps distribute pressure evenly and reduces the risk of reinjury.

These combined approaches are essential for managing hip IT band syndrome, maintaining long-term joint health, and preventing future overuse injuries.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

ITB Tendonitis

Surgical Treatment

Surgery is rarely necessary for iliotibial (IT) band tendonitis, as most cases respond well to conservative, non-operative treatments. With proper rest, physical therapy, foam roll & stretching, inflammation and pain usually subside over time. In fact, most patients with outer hip or lateral thigh friction caused by IT band irritation recover fully without surgical intervention.