It often starts as a subtle annoyance—a slight friction on the outside of your knee that gets better the more you feel warmed up. But then it stops getting all the way better during a run, and may even start to hurt when you’re sitting at home.
Many people with repetitive strain injuries like iliotibial (IT) band syndrome usually experience a similar pattern from there. You rest for a day or two, try to run again, and the pain returns immediately. Eventually, you make an appointment with a doctor or physical therapist. You get the diagnosis and treatment you’ve been looking for, but your routine is disrupted for weeks if not months to allow the joint to fully heal.
But not everyone has a perfect plan for preventing this type of injury from happening again. Getting back to the routine you love requires more than just waiting for the pain to subside; it requires a comprehensive strategy to address the root cause so you can keep running after IT band syndrome.
How to treat iliotibial band syndrome
If you’re currently experiencing pain in your knee that hasn’t been diagnosed, the first step to returning to activity is seeing a specialist or your primary care provider. And unfortunately, treating IT band syndrome effectively usually requires a period of rest that can feel frustratingly long for someone used to daily activity.
If you ever have questions about the pace of your recovery or if the pain comes back quickly despite significant rest, get your doctor’s opinion or visit a physical therapist. They can rule out other knee issues and give you a more comprehensive plan to allow your knee to heal.
Regardless, keep in mind that the knee is a complex joint, and the IT band is a thick, fibrous tendon—not a muscle. Tendons generally receive less blood flow than muscles, meaning they often take longer to heal.
Even when your symptoms disappear during daily walking, the tissue might not be ready for the repetitive impact of running. Patience here is your most valuable tool; rushing back too soon often restarts the clock on your recovery.
How to return to activities after IT band injury
Once the acute pain is gone, your goal shifts from treatment to prevention. You don't want to just return to running; you want to return to running with a reduced risk of pain. The best way to prevent re-injury is to have a comprehensive plan in place based on your specific anatomy and the type of activity you enjoy.
For many athletes and active individuals, IT band syndrome is caused by biomechanical issues: how your foot lands, how your knee flexes, and how your hips stabilize your body. If you return to running with the exact same technique that caused the injury, the result is likely to be more of the same.
To break the cycle of repetitive stress injuries like this, you generally have two options to consider: changing your footwear or getting fitted for custom orthotics.
The strategy of changing shoes
A common first step for runners recovering from IT band syndrome is changing their shoes. Many people who suffer from IT band syndrome have success when they simply buy a new type of shoe that alters their gait or better supports their affected knee as they exercise. For example, if you overpronate (your foot rolls inward excessively), a shoe with sturdy interior support might help align your leg and reduce strain on the IT band.
However, finding the "perfect" shoe might turn out to be more of a guessing game than a science. Even in the best-case scenario, you might be able to test out a new pair on an in-store treadmill for two minutes, but the true test won’t come until mile 20 on pavement. Unfortunately, once you wear shoes outside and break them in, they usually cannot be returned. If the pain returns, you are left with an expensive pair of lawn-mowing shoes and are back to square one.
Furthermore, you will only get the biomechanical benefits when you are wearing those specific running shoes. If you spend your work day in boots or your weekends in sneakers, your feet aren't getting that support, which can contribute to overall fatigue and poor mechanics. To stay supported all the time, you would basically need to replace your entire shoe collection.
The benefits of getting custom orthotics
The second, and often more comprehensive, option is utilizing custom orthotics. While this route typically involves a higher one-time cost compared to a single pair of sneakers, the long-term value and versatility are significant.
Custom orthotics are designed to correct your specific biomechanical irregularities—whether that be high arches, flat feet, supination (rolling outwards) or severe pronation—regardless of what shoes you wear. Because they are inserts, they can be slipped out from your running shoes to your work boots, dress shoes, or casual sneakers. This ensures that your body is properly aligned the whole day, not just during your workout or recreation time.
Another distinct advantage over new shoes is the adjustability of orthotics. If your needs change or if the orthotic needs a slight modification after you’ve worn it for a few months, that is an option. With a shoe, you’re usually stuck with how it was manufactured. With a custom orthotic, you have a tool that can evolve with your recovery.
Ready to run right?
Running during IT band syndrome isn't an option, but running after it certainly is. You don't have to sacrifice your active lifestyle or live in fear of the next flare-up. By addressing the root biomechanical causes of your knee pain, you can hit the pavement with confidence.
At Biocorrect, our custom orthotics are hand-fabricated with durable materials and are customized specifically to your needs and foot anatomy. Unlike a mass-produced shoe or over-the-counter orthotic that assumes everyone with a size 10 foot has the same arch height, a custom orthotic meets your foot exactly where it is. This precise support helps reduce the strain on the IT band by preventing the internal rotation of the leg that often triggers the overuse injury.
If you are ready to stop the cycle of injury and recovery, we are here to help. Request an appointment today to schedule an in-person appointment or set up a virtual assessment from the comfort of your home.
