Iliotibial band (IT band) syndrome is a common overuse injury, affecting as many as 12% of runners. It happens when the tendon from your hip to outer knee tightens and irritates your outer knee area, causing pain. (Source: Temple Health Blog.) The definition of a syndrome is: a group of symptoms which consistently occur together, or a condition characterized by a set of associated symptoms. Labeling the condition as a syndrome suggests that it is unavoidable and un-repairable. Fortunately for sufferers, nothing could be further from the truth.

You may experience sharp debilitating lateral knee (outside knee) and lower leg pain, however being diagnosed with something appearing out of the blue, that you have no control over, is simply not true.

The true cause of your IT band symptoms is more about function and/or dysfunction, but let's first understand what the IT band really is.

The IT band is sometimes thought to be a muscle. However, it is actually a superficial layer of connective tissue on the outside of your thigh, extending from the outside of your pelvis, over your hip and knee, inserting at the tibia just above the knee. The major roll of the IT band is to control and decelerate the inward movement of your femur (thigh bone) as you are walking and/or running. The IT band is crucial in stabilizing the knee in gait (i.e. running or walking).

You may ask: "Then why does my knee hurt?" Typically you will experience pain localized over the lateral knee or outside of the knee. The pain usually sets in after about 2 or 3 miles of running or walking and is intensified with continued running. Pain frequently develops during an incline and is often relieved when resting.

Understanding why your outer knee experiences pain is not complex. During your running gait, your IT band moves from behind your femur (big leg bone) to the front of it. The continual rubbing of the band over your bone, combined with repeated flexion and extension of your knee, causes irritation.

Now that you understand what the IT band is and why it gets irritated, let us think about the causes of this type of injury. The believed cause of IT band syndrome is commonly misdiagnosed and treated as a tight Tensor Fasciae Latae muscle (TFL muscle). A regime of stretching exercises directly related to the IT band and a layoff in running are commonly recommended. Eventually the area feels better and you resume running again. But, sadly, the pain returns and you have done nothing to rebalance the muscles and connective tissue. This is often frustrating since you have done everything prescribed, and to no avail, the pain returns.

Let's understand the true causes of your lateral knee and lower leg pain symptoms, relative to the tight IT band. First, we must look for the root cause of the dysfunction. As it turns out, imbalance of the hip/pelvis is the main culprit. When the hips are imbalanced nothing above or below them is balanced. Think of it this way: if running is really the problem, then why is it that only one leg hurts? We also know that running on uneven surfaces isn't the problem. If so, all runners would suffer with this type of issue. Sometimes the increase in running and intensity will be blamed. If that were the case, every runner would encounter these same pains and symptoms.

Now let's discover the underlying cause. Drum roll, please! It's your posture! Yes, it is as simple as that. Whether it's a restriction in your hip musculature, a weakened lateral hip flexor, or leg length discrepancies, the root cause must be addressed in order for the IT band symptoms to subside on a permanent basis. Postural imbalances such as hip disparity, posterior or anterior tilt of the pelvic girdle, and hip elevation or rotation are causing your body to recruit the wrong muscles to do the work.

If you want to be pain-free when running, you must first realign your posture. Meaning you must get your joints and musculature balanced from top to bottom, front to back, and side to side. It isn't rocket science. If your foot, ankle, knee, and hip are misaligned, the result will eventually be pain. The same goes for the rest of your body. Examine yourself in a full-length mirror with running attire on. Look at your knees: are they aligned with your feet? Look at your shoulders: are they level? If you notice that your feet and knees are going in different directions and your shoulder is higher on one side than the other, you are out of alignment. When your posture is compromised, one or more of these factors will arise and the eventual result may be IT band syndrome.

The good news is that these imbalances can be corrected with Posture Alignment Therapy.