If you’re an athletes or runner who’s been dealing with persistent pain on the outside of your thigh or knee, there’s a good chance someone has told you to grab a foam roller and go to town on your IT band.
And if you’ve tried it, you probably noticed that it didn’t do much.
At Cohen Health and Performance, where we specialize in physical therapy for runners, we see this all the time—runners struggling with IT band syndrome who are stretching and rolling with little to no relief. The truth is, there’s a much more effective approach to solving this common issue.
Understanding the IT Band: It’s Not a Muscle
The iliotibial (IT) band is a thick, fibrous piece of connective tissue—known as fascia—that runs from your hip down to the outside of your knee. Unlike muscle tissue, fascia doesn’t stretch or adapt the way muscles do. In fact, in cadaver dissections during our physical therapy training, we saw just how tough and dense this tissue is.
That means your foam roller isn’t “loosening” the IT band. You’re not breaking up tissue adhesions. And you’re definitely not lengthening it. So what can you do?
Focus on the Muscles That Influence the IT Band
The key to managing and eliminating IT band pain lies in addressing the muscles that attach to it:
- Tensor Fasciae Latae (TFL)
- Gluteus Maximus
- Gluteus Medius
These muscles influence the tension and position of the IT band. If they’re tight, weak, or imbalanced, they can pull on the IT band in ways that cause irritation—especially during repetitive activities like running.
Why Hip Mobility Matters
One of the first things we assess in our physical therapy for runners sessions is hip mobility. If your hip joints don’t move well, the muscles surrounding them can’t work through their full range of motion. This can lead to stiffness, compensation, and excessive tension placed on the IT band.
Improving hip mobility creates a healthier foundation for movement and reduces the mechanical stress on the IT band during running.
Strength Balance Is Critical
Another common issue? Muscle imbalances.
For example, if the TFL (front/side of the hip) is more active than the glutes (back of the hip), it can pull the IT band forward and create friction or irritation. A strong, well-functioning gluteal complex helps counterbalance this tension and stabilize the pelvis—especially important with each stride during running.
At Cohen Health and Performance, our team of physical therapists uses targeted strength work to restore that balance and reduce IT band stress.
Pelvis Positioning
How your pelvis and rib cage stack during movement matters more than most runners realize. Many runners adopt an anterior pelvic tilt (hips tipped forward), which changes how muscles like the glutes and TFL function. This posture can amplify IT band tension and make even “normal” movement patterns painful.
Addressing postural habits is an important part of our assessment and treatment process.
Movement Patterns and Running Technique
Finally, we always look at how our patients move—whether it’s squatting, lunging, or running. Movement strategies that rely too heavily on compensation patterns (e.g., overusing the quads or collapsing through the hips) can place unnecessary strain on the IT band.
If you’ve never had your movement or running gait analyzed by a physical therapist, this is a great first step.
Physical Therapy for Runners: Get to the Root of IT Band Pain
The bottom line: foam rolling your IT band might provide short-term relief, but it doesn’t fix the root cause. If you’re dealing with ongoing lateral thigh or knee pain, the answer lies in a comprehensive assessment of your mobility, strength, posture, and movement patterns.
At Cohen Health and Performance, we specialize in physical therapy for runners. We’ll help you:
- Identify the true source of your IT band pain
- Build a personalized program to restore function and eliminate discomfort
- Keep you running stronger, longer, and pain-free
Ready to Get Rid of IT Band Pain for Good?
Visit us at our Bethesda or McLean locations
Click here to schedule a 1-on-1 evaluation with one of our Doctors of Physical Therapy
Don’t let IT band pain sideline your training. Let’s get you back to what you love—stronger and smarter than ever.
