Many people experience IT band pain at one point or another. It is a common injury, most frequently seen in younger, athletic individuals. Typically these individuals are making simple training mistakes that can be corrected.

Mistakes in Training

Below are descriptions of common training mistakes that can lead to IT band friction.


Lack of strength or flexibility. If the muscles at the inside of the thigh, called hip adductors, are weak, then the IT band can become tight. Similarly, if the hamstrings or other thigh muscles are too tight the IT band may also become tight.

Skipping warm-up exercises. While it is tempting to jump right into a workout, muscles and soft tissue will benefit from 5 or 10 minutes of warm up exercise before building up to more intense activity.

Ramping up training too fast. An ambitious training schedule is not always good for joints. To avoid IT band syndrome and other injuries, athletes are advised to slowly add to the length and intensity of their workouts over several weeks or months.

Wearing improper footwear. How the foot lands on the ground can affect not just joints in the foot and ankle, but also the knee, the hip, and the muscles and other soft tissue that support those joints. Proper footwear can improve biomechanics and reduce or prevent IT band pain.

Running on poor surfaces. Runners increase their risk of IT band friction syndrome by running on a surface or terrain that is:

  • Too hard (e.g. concrete)
  • Hilly
  • Uneven or banked (such as the side of the road, where it slants downward towards the curb)

Cycling with poor form. Cyclists increase their risk of IT band friction syndrome if:

  • The bike seat is too high, forcing the leg to extend too much, which can aggravate IT band problems
  • Gears are set too high, forcing the leg to work harder at fewer RPMs
  • The pedals and toe clips are not adjusted properly for the individual

While runners and cyclists are especially susceptible to IT band pain, it can affect any athlete that engages in repetitive knee motion. Speed-walkers, basketball players, soccer players, and weightlifters are other examples of athletes who may experience IT band syndrome.


Other risk factors

An individual may have a great training program but be predisposed to IT band pain because of biomechanical problems or misalignment of joints. People who are predisposed to IT band friction syndrome include:

  • People who have bow legs
  • People whose legs are slightly different lengths

For men, being younger than 34 years of age is also a risk factor. 1 Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002 Apr;36(2):95-101. PubMed PMID: 11916889; PubMed Central PMCID: PMC1724490.

Dr. Christian Foglar is an orthopedic surgeon specializing in sports medicine and trauma and reconstructive surgery. He practices at Advanced Orthopaedics in San Jose, CA, and is a lieutenant colonel in the U.S. Army Reserves.