As temperatures rise in the Northeast, so does running mileage. But with that increase often comes a familiar, nagging pain on the outside of the knee. It’s a common complaint, frequently tied to the infamous iliotibial (IT) band syndrome. We’ve heard it from hundreds of frustrated runners:
“I don’t get it—I’ve been stretching and foam rolling my IT band. I should be fine!” That frustration is real. But so is the relief that comes when they finally learn why stretching won’t prevent IT band pain.

😖 Why Stretching Won’t Prevent IT Band Pain

IT band syndrome is not a flexibility-related injury, it’s a load-based injury For example, this research assessed runners and followed them to see if a tight IT band leads to running injury. What did they find? IT band syndrome was the most common injury in this running group, and NOT ONE OF THEM had a tight IT band. 

Building off of that, other research has shown that the IT band has limited to no ability to stretch, even under significant force.

🤔 Why Does IT Band Pain Happen?

IT band pain is most commonly caused by load management issues—that is, your body is being subjected to more force than it’s prepared to handle. This is especially true when increasing running volume or intensity too quickly without adequate conditioning.

Key factors include:

• Insufficient variation in running terrain and workload, leading to tissue overload
• Sudden spikes in mileage or intensity (example: aggressive ramp up from 0 miles a week to 10 miles)
• Lack of strength in the muscles supporting the lateral thigh, hip, and knee
• Running downhill or repetitive movements that place eccentric load on the IT band

✅ What Actually Helps Prevent IT Band Pain

1. Manage Your Running Load Wisely

Gradually increase your mileage and intensity. If you’ve taken a break during winter, start with shorter runs, intervals, or easy-paced efforts. Slowly build up over weeks to avoid overwhelming your tissues. Try not to progress mileage greater than 10-20% per week, include a deload in mileage every 4-6 weeks of 30-50%.

2. Build Strength Across the Whole Leg

Strong muscles help absorb and distribute forces that would otherwise stress your IT band and knee. 

3. Include Eccentric and Plyometric Training

Running downhill stresses the IT band through eccentric loading. Training your muscles with controlled eccentric movements (like slow, controlled step-downs) can help prepare the tissues to tolerate these forces. Plyometric exercises also improve tendon elasticity and resilience.

4. Mix Up Your Running Terrain

Incorporate uphill running to emphasize the posterior chain (glutes, hamstrings, calves), which can help balance forces through the leg. Varying terrain and slopes reduce repetitive stress in one pattern.

5. Use Recovery Tools for Symptom Relief, Not Prevention

Foam rolling or soft tissue work on the IT band may help reduce discomfort when pain occurs, but won’t prevent injury. Similarly, stretching might ease soreness but doesn’t change tissue properties enough to stop pain from developing.

🏃 Final Thoughts

Preventing IT band pain is about smart training, load management, and strengthening, not stretching the IT band itself. Prepare your body to handle the forces of running by progressing gradually and building functional strength. This approach will keep you running strong, without being sidelined by that frustrating outer knee pain.

Want to prevent injuries and recover smarter? Grab our free resource [here] on what to prioritize before and after the most common sports injuries.

Author: 

Dr. Dillon Caswell, PT, DPT, SCS

Hope Evangelist | Top-Selling Author & Speaker | Human Performance Expert