Other activities: How they may affect IT Band Syndrome


Although widely considered a low-impact activity, hiking is a common cause of IT Band Syndrome.  Like running downhill, not only is hiking downhill typically a trigger activity, but it shares the mechanics of “controlled falling,” as does walking.  Perhaps due to its knee-intensive exertion, running downhill strenuously activates the quads and knees.  Whereas running uphill ignites the gluts and hamstrings, downhill running deploys the knees as a stopping or “breaking mechanism.” Subsequently, this creates great tension in the connective tissues around the knees, not mentioning the IT band.  The same operation occurs when going downstairs versus upstairs.

Like all recreational activities, hikers should methodically ease into their sport to reduce the risk of IT Band Syndrome.  Training is paramount in preparing for a serious hiking trek.  While finding a mountain to train is not practical, other alternatives like hills, stairs and exercises like squats, may aid in avoiding the syndrome.

Especially descending downhill, hiking poles are very useful in supporting body weight.  In circumstances zig-zagging sideways, the poles help stabilize the momentum of the body moving downhill.  Igniting strain, the side-to-side force can build strong tension in the IT band.



Stairs can be IT band’s worst nightmare, especially for those runners whose multi-level homes house four or more floors to climb.  Repeatedly moving up and down several flights of stairs may ignite irritation in the knees.   Again, the golden rule of avoiding the 30-degrees knee flexion can apply to everyday task of climbing up and down the stairs.  While pivoting a bit sideways and maintaining one leg bent as much as 8o degrees on the upper stair, shift the other leg almost completely straight on the lower stair.  Then move up one step at a time.  While slower and a tad awkward, this technique, nevertheless, can be very helpful in tempering any irritation caused by the syndrome.


Sitting for long periods is an bad idea after a lengthy run.  Long periods of desk-bound activity can allow the IT band area to tighten.  In such scenarios, if you initially feel the brunt of the IT band flaring up, you can carefully walk off the pain by loosening up the area.  However, if you’re relegated to extensive days of sedentary work on a chair, then the chances of the IT band tightening are highly likely, developing further inflammation.

Avoid posturing your leg at the dangerous 30-degree angle, by either fully extending your legs underneath the desk, or flexing it to a 90-degree angle.  Either alternatives help avert the dreaded 30 degrees of pain.  Shifting between fully straightening, to bending your knees at a right angle, aids in relieving any sores, while improving circulation in and around the IT band.

While crossing your legs can either alleviate or exacerbate your IT band pain, from my experience crossing my legs and leaning forward a bit helps in stretching the area.  Statically sitting in one position often leads to irritation.  Therefore, again, I’d recommend standing up and walking around to stretch the lower legs.

A light run in the morning and then some stretching afterward may be helpful if you plan to spend much of the day sitting. This gets the IT band area more loose for the day. Walk from time to time and even at lunch to keep the IT band and associated muscles loose.

ITBS IT Band syndrome activities sitting


Avoid deep knee bends. This is even more irritating to the IT band than the 20 to 30 degree danger zone.



Bike riding

Bike riding also irritates the IT band however much less than running. The strain has been estimated at about 10% of running. If you like biking but suffer from ITBS then you can reduce the strain even further by lowering the seat so your knees do not bend through the ITB danger angle. This is not practical for competitive cycling but allows you to enjoy bike riding without much stress on the IT band. I have cycled 50 miles in a day without irritating the IT band.


Other sports
Cross training is recommended but careful consideration should be taken when choosing the activity. Avoid activities with abrupt and intense turns that cause knee rotations or deep knee bending. Be cautious with sports like basketball, tennis, football, soccer, etc. as these can re-irritate a healing IT band strain. Stick to playing catch or simple net play in tennis, for example, to avoid deep knee abrupt changes in direction or deep knee bending.





Sleep is the most important healing time for the body. However this may be a time of irritation for the IT band instead. Sleeping with a leg bent at an angle around the 30-degrees impingement position of IT Band Syndrome may create strain for long periods. An alternative is to keep the legs straight, only slightly bent, or bent beyond 45 degrees. Alternating between straight and about a 90-degree knee bend when waking at night may reduce irritation and improve recovery.

Sleeping on the side can cause increased tension of the IT band of the upper leg and increase the IT Band Syndrome irritation. Sleeping with a pillow between the knees, as shown in the illustration here, can reduce the tension and strain.

ITBS IT Band Syndrome Sleeping


Waking up
The tendons, ligaments, and other connective tissue of the body tighten up while we sleep or sit for long periods. Moving extra slow when first getting up can be helpful in avoiding unnecessary strain. Take it extra easy the first 10 to 15 minutes in the morning and take smaller and somewhat stiff legged steps. This gives the IT band needed time to slowly stretch and warm up. For example, avoid jumping right out of bed and running down a couple flights of stairs with a lot of deep knee bending.


Abrupt movements
Any other abrupt or sudden movements such as jerks or twists of the knee should be avoided, especially when irritation is present. As discussed above, move slowly when you get up from a chair or bed and take the first steps gingerly.


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