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The most important thing about an Iliotibial Band Syndrome (ITBS) injury is to determine and correct what is causing it.

The first step is to give it sufficient time to heal properly. That usually means no running for at least a couple of weeks, and sometimes up to 6 weeks in severe cases. In most cases, trying to “run through the injury” is counterproductive. "Busting your butt" in an attempt to strengthen the ITB to get past this problem just exacerbates the problem.

The next step is to analyze the potential causes of the injury.


ITBS can be caused by simply too much, too soon. If that's the case, then a more gradual approach to a running program can be the answer. More conservatism in building mileage when getting back to running after it heals could be the simple solution.

Perhaps the most common cause of ITBS is overpronation, which can be natural, induced or both. Anyone with a persistent ITBS problem should have a gait analysis performed to check out his/her biomechanics. It could well be that one has a very common biomechanic imperfection....overpronation....and is simply running in the wrong type of shoes. Motion control and stability shoes are designed to control overpronation. Any other type of shoe is brutal on the knees of an overpronator and almost guaranteed to bring on ITBS.

Running on a slanted surface, such as the shoulder of a canted road, can induce overpronation, even in someone who is not a natural overpronator. If one runs regularly on such a surface, then either finding someplace else to run or altering directions on the same side of the road periodically so that one isn't always running with the same foot "uphill" can be a solution.

ITB stretching is an absolute "must" for anyone who has had an ITBS problem. In fact, ITBS is so prevalent among runners, it's a good idea for everyone to ward off potential problems. The ITB's should be stretched after every run....no exceptions!

I had ITBS 24 years ago when I was a beginning runner. Mine was caused by all of the factors that I have mentioned in this post:


  • Too much, too soon.
  • Natural overpronation on my right leg.
  • Running exclusively in racing flats!!
  • Regular running on the shoulder of a canted road.
  • Never stretching.

I visited a sports medicine clinic where I was told to:

  • Stop running for a few weeks.
  • Burn my racing flats!!
  • Buy stability shoes.
  • Build mileage and intensity more gradually when I started running again.
  • Get off the shoulder of the road or run half my mileage in each direction.
  • Stretch my ITB's after every run.


I have followed that advice for 24 years with no more ITB knee problems while running almost 25,000 miles and 202 races, including 21 marathons.