How Runners Actually Heal IT Band Syndrome: The 3-Step Rehab Formula

Marie Whitt
3 days ago
7 min read

If you’ve ever had IT Band pain creep up on you mid-marathon training cycle and thought,

“I’ll just foam roll it out, do a few clamshells and single leg bridges, and I’ll be fine…”

You are leaving yourself wide open for a repeat injury.

Here’s the truth:

Because gravity exists, running slams your body with up to 2.5x your body weight every single stride.

And some of your joints like your patellafemoral joint (your knee) experience up to 6-7x your body weight.

What are you supposed to do with these fancy PT-research numbers and what does this have to do with ITBand pain?

I want you to think about your running shoes.

If you were training for a marathon, would you race in the SAME shoes you used at the start of your training cycle?

Probably not.

Because they've got miles on them, the foam is broken down, etc.

Start treating your muscles like your running shoes.

Be aware of the mileage and intensity you're demanding of your body! But instead of swapping out and buying new shoes, embrace the muscle-equivalent of new shoes: strength training.

In this guide, I’ll break down the exact 3-phase rehab formula runners need to finally fix IT Band Syndrome, plus the strength exercises that get you back to running pain-free, stronger than before.

Lets jump in.

What Your ITB Needs to Survive to Run:

Running is high impact.

And your body needs to specifically survive 3 different kinds of "impact" or load:

peak load (the shattering impact your body experiences with every stride)
cumulative load (the overall load your body experiences after you 10k)

and

Energy storage and release...huh?

That last one can be a little tricky, but I explain it all HERE in greater detail in my IT Band Part 1 blog post.

But for a quick recap: start thinking of your ITB more like a spring and less like a stiff, immovable sheet of plastic.

Your IT Band acts very similarly to your achilles tendon, absorbing energy as your foot hits the ground, storing it briefly, and then using that "free" energy to propel and power you through your next stride.

But in order for your ITB to be able to do that pain free and efficiently, you have to train it.

That's why simply knowing these different kinds of load exist is important because they are the EXACT reason each of these different rehab phases exist.

(so no, you can't skip the plyos. you WILL get injured again.)

The 3-Phase Rehab Formula to Heal IT Band Syndrome (and Keep It Gone)

PHASE 1: Heavy Slow Strength Training:

Typically if your IT Band is fairly spicy, we can still find some strength exercises your body will tolerate.
This phase is crucial because it helps prepare your body for PEAK LOADS so you don't have pain with every stride, especially when you're running down hill

PHASE 2: Plyometrics

Don't knock these because this is the missing piece that most runners ignore. Plyometrics teach your IT Band to efficiently mange ENERGY STORAGE AND RELEASE
they also help you make the transition from heavy slow strength training to return to running, and can even make this return FASTER!

PHASE 3: Return to running

This is where we phase out the plyometrics because you're running again and building up your body's and ITB's tolerance to the CUMULATIVE LOAD of running for miles and miles.

please note...

if your IT Band is very spicy, and these exercise are too much for you right now, don't do them.

This doesn't mean you're hopeless. I have answers and specific exercises for you and I would love to work with you one-on-one to manage your ITB issues and get you back to running pain-free, faster, and stronger again. If you want to learn more about what that looks like, check out my Running Rescue calls here:

It's Time for Your Running Rescue

These exercises are for the runner with a niggle that won't quite go away and they can still run with only mild pain but they know...

Things could flair and stop them in their tracks.

So if you're in that no-man's land of "it's not bad enough that I need to go to the doctor" but "I can't run as much or as fast as I'd like because this hurts"...these are for you.

The Exact Strength Exercises Runners Need to Heal IT Band Syndrome

Strength Circuit:

Split Squat: Injured Leg BACK!

Beginning: 3 x 15 with bench height low, progress to high
Progressed: 4 x 8 @ RPE 7-8 with bench height low, progress to high

Split Squat: Injured Leg FORWARD!

Beginning: 3 x 15 with bench height low, progress to high
Progressed: 4 x 8 @ RPE 7-8 with bench height low, progress to high

*Single Leg Box Squats

4 x 8 @ RPE 7-8 with bench height HIGH, progress to LOW
optional*

Plyometric Circuit:

Alternating Lunge Jumps

4 x10 reps ea leg
increase height of jumps as able

Lateral Skaters

4 x 10 reps each leg
to progress: can jump off and back onto an exercise step

How These Exercises Heal IT Band Syndrome and Keep You Running Strong

Split Squat: Injured Leg BACK!

I did a double take too when I first learned this exercise...
Start by setting this up like a Bulgarian split squat. But here’s the twist: your injured leg goes BACK with the top of your foot resting on a mat, bench, or table. (Yes, the injured leg is the one elevated.)
Why? Because as you lower down, bending the front knee, you eccentrically load your IT Band, meaning you are making it stronger in lengthened or long-running-stride position. This type of strengthening is exactly what helps rebuild tendon strength to handle the load of running.
YOUR CUE: “Lower yourself down as much as possible by pushing through the top of the foot that’s on the bench.” This helps you control the lowering phase and appropriately load IT Band (and the TFL muscle it plugs into) in the right way.

Split Squat: Injured Leg FORWARD!

I know you still think these evil, but we're doing them anyway haha...
Now lets bring the injured leg in front so it becomes the stance leg.
This becomes your regular Bulgarian split squat, focusing more on loading your glute max.
PRO TIP: You don't need to push through the foot on the bench anymore.
Progression Tip FOR BOTH VERSIONS: be sure to start with a lower bench or surface, then gradually raise the height. As you increase the height, you "wind up" the IT Band, placing more load on it. Once the increased height feels fine, feel free to add light weights and work your way up to heavy.

Single Leg Box Squats

These are optional for a reason...
THE SECRET: when you're in that awkward in-between phase of "it hurts, but not terrible, but enough...", strength training your hip muscles and specifically your glutes can do a world of good.
This single leg box squat is a great alternative for working on single leg strength without irritating or overload the IT Band (because if yours is really cranky, lunges are NOT going to feel good).
THE REASON THESE WORK: will obviously working your glutes, and single leg stability, these are pretty great at addressing quad eccentric strength (Read: slow and controlled sitting on the box; no plopping!)

Alternating Lunge Jumps

Trust me: we'll suffer through the burn together...
Start by imagining your split squat, but add a jump and switch legs mid-air. (easy, right? lol)
PRO TIP: make these jumps small at first focusing on a soft landing. Then jump higher, building height as you're able
THE REASON YOU NEED THIS: this particular plyometrics strengthens your IT Band in the sagittal plane (forward/back motion), helping it learn to handle energy storage and release in a position that looks like running (i.e. the exact motion of you pushing off and absorbing impact while your next stride).
Your TFL (that small hip muscle at the front of your hip where your IT Band begins) plays a big role here, helping manage the load that transfers through the IT Band with every jump, landing, and eventually, stride.

Lateral Skaters

If you think you've seen these before, you'd be right!
I'm always up for a good skater jump. It makes it even better that skater jumps train your IT Band in the frontal plane (moving side-to-side). And although we don't like like a crab, this becomes a motion we runners often neglect, but desperately need for stability.
Push off side to side like a speed skater, landing on one leg, and controlling the landing, challenges your lateral (outside) hip and teaches your knee and IT Band to handle side-to-side forces. This comes in handy in case you're thinking of hitting the trails and need to traverse changing, rocky terrain
PRO TIP: You can progress this exercise by adding height. You start with the injured leg on a step, hopping off and sideways like you were before, and then back up. But remember: land softly and with control! This added height increases the load-demand even more on the lateral part of your knee and hip, preparing your IT Band for intensity-demands of a speed workout.

WRAPPING UP

Can I keep running while doing these exercises?

You can but...

I need you to pay attention to how you feel the next day.

Remember: your IT Band acts like a tendon which means, if you've done too much, it'll let you know the following day.

Here are my suggestions:

cut your running mileage in half
Do these exercises 3-4x a week
and be aware of next day pain, especially if it's GREATER than a 3/10 (0 is no pain; 10 is you need to go to the ER)

The reason being: if your pain SPIKES, you gotta chill. You can still do the strength exercises as long as they don't increase pain, but it's wise to decrease the intensity, meaning drop the weight or lower the height at which you're performing the split squat.

If you're sucessfully able to complete the strength exercises WITHOUT any increased pain, congrats! Go ahead and progress to harder version or add some more weight.

But please be aware...

this is NOT the end-all-be-all for ITB exercises.

Meaning...I prefer to be much more nuanced.

I'd rather write you a very specific, individualized program based on your running needs and goals, discomfort/pain levels, and how easy or hard the exercises are.

These are just meant to get you started.

Will they help clear up a flare?

Hopefully!

If they only seem to help at first, but don't completely solve your problem- THIS IS OK.

This a sign that a Running Rescue call WILL work and will help get you back to running stronger, faster, and pain free. Feel free to check out my Running Rescue Call here: