Part of IT band syndrome

IT band exercises to avoid, and what to do instead

The IT band exercises to avoid group into four families, not a list of names. Anything that bends and straightens a loaded knee over and over through about 30 degrees. Anything that lets the working leg cross the midline of your body. Downhill and cambered running. And the machines that hold the knee in that bent range under load, which for a runner Geisler (2021) names as the stair stepper, the stationary bicycle and the rowing ergometer during the first calming weeks. The knee angle is what matters, not the name of the exercise: on MRI, Fairclough and colleagues (2006) found the band compressed against the bony bump at the outside of the knee at 30 degrees of bend. Those four groups follow from that angle and from the way the leg moves, not from trials that tested the exercises themselves. Stopping everything is the commonest mistake, and it leaves the hip weaker than it started. Side lying hip work, flat walking in amounts you tolerate and swimming are usually kept, not dropped. The rule that replaces the whole list is the next morning: if the outside of your knee is no sorer the following morning, the exercise can stay. If your knee swells up, locks, gives way or clicks painfully, that is not a training problem and it needs looking at the same day.

Warning signs, and when to get help

What exercises should you avoid with IT band syndrome?

Here is the list people come for. Then the reason a list is the wrong shape of answer.

Loaded repetition through a bent knee. Deep squats for high repetitions, step ups and step downs, the leg extension machine, and running itself.
Anything that lets the working leg cross the midline of your body. The curtsy lunge, the crossover step up, and the standing stretch where you cross one leg behind the other and lean away.
Downhill running, and running on the same road camber every day.
The machines that hold the knee in the bent range under load: the stair stepper, the rowing ergometer, and the stationary bicycle in some positions.

Four groups, not twenty names. A gym holds far more exercises than any avoid list covers, so a list on its own leaves you stuck the moment you meet a machine that is not on it.

One more thing before the detail. Turning everything off is the commonest error, and it costs you the thing that actually gets better. In a 2024 review of conservative treatment in runners with this condition, 13 studies covering 201 runners, hip abductor strengthening was the ingredient that appeared most, and pain and function improved over 2 to 8 weeks (Sanchez-Alvarado and colleagues, 2024). The authors could not pool the results because the studies differed too much, and 6 of the 13 were case reports or case series, so this is a direction of travel rather than a dose. It is still enough to say that rest on its own is not the plan.

The three that usually stay are the side lying hip work, flat walking in amounts you tolerate, and swimming. All three come up again below.

Why the knee angle matters more than the exercise name

Because the problem is a position, not an activity.

Fairclough and colleagues (2006) dissected the lower part of the band in 15 donated bodies and scanned 6 healthy volunteers and 2 athletes who had the condition at the time. The band turned out to be anchored to the lower thigh bone by fibrous strands, so it cannot roll forward and back over the bony bump the way the old friction story described. What it does instead is press inward on a layer of fat under it that is full of blood vessels and nerve fibers, and on their MRI scans the band was compressed against the bump at 30 degrees of knee bend, as the shin turned inward, while it moved away from the bump as the knee straightened.

Muhle and colleagues (1999) looked at the same corner a different way, imaging 6 donated knees at full extension, at 30 degrees and at 60 degrees. In all six there was no bursa between the bony bump and the band, and the pouch of joint lining on that side (the lateral synovial recess) did not reach that bump at any of the three angles. So what sits there is the band, the bone and the fat layer in between, which is the structure the knee angle acts on.

So ask a different question about an exercise. Not whether it is good or bad for the iliotibial band, but how many times it takes a loaded knee through roughly a quarter bend, and whether the leg stays under the hip while it does. A single deep squat passes through 30 degrees twice. Forty of them pass through it eighty times, under load, which is a different exercise wearing the same name.

That is also why the answer changes week to week. A movement that is provocative while the knee is sore is often completely fine six weeks later, and the IT band syndrome program is built in stages for exactly that reason.

The movements that take your leg across your body

This group gets missed, and it is the one with a measurement behind it.

Noehren and colleagues (2007) followed healthy female recreational runners for two years. Eighteen of them developed IT band syndrome, and compared with matched controls, their running mechanics at the start of the study showed significantly greater peak hip adduction and greater knee internal rotation. Rearfoot eversion and knee flexion were no different. In plain terms, the group that went on to get it was already letting the thigh fall inward as the foot landed.

Hip adduction means the thigh moving toward and across the midline of your body. Once you know that is the position of interest, a set of gym exercises sorts itself out:

The curtsy lunge, which steps one leg behind and across the other on purpose.
The crossover step up, for the same reason. Both were deliberately left out of our own program.
The standing IT band stretch, where you cross one leg behind the other and lean away from the sore side. Pepper and colleagues (2021) measured higher stiffness in the lower part of the band in 10 degrees of hip adduction, which is roughly what that stretch does.
Running or walking with a narrow line, where each foot lands close to or past the midline. Narrow treadmill running and track work on a tight bend both do this. Nobody has tested either in this condition, so that last one is reasoning from the same position rather than a finding.

Sitting with your legs crossed belongs in the same family, and it is a bigger slice of most people's day than their training is. The hip version of that habit is covered on sitting and crossing your legs with outer hip pain, which is worth a look if your pain is higher up the thigh.

Squats, lunges and the gym

Nobody needs to give up squatting. Most people need to change the depth, the number and the tempo for a few weeks.

Depth first. A squat that stops before the knee passes much beyond a quarter bend keeps you out of the range that provokes, and a mini squat held for a couple of seconds loads the thigh without the repetition. Depth is also where a lot of accidental provocation hides: a box squat to a low box, a leg press set deep, and a bike saddle that is too low all put the knee in the same place.

Number next. Three sets of 15 deep squats is 45 squats and 90 trips through the angle. The same session rewritten as 3 sets of 8 at a heavier load is 24 squats and 48 trips, a little over half the exposure. If you want to keep training heavy while the knee settles, fewer repetitions with more weight is usually the compromise that works, and it is a fair thing to ask your physio (physical therapist) about at your next appointment.

Then the specific ones worth parking for now. Forward and reverse lunges for high reps, walking lunges, step ups and step downs on a tall box, the leg extension machine, and jumping work of any kind. Our page on weightlifting injuries sorts the common gym complaints by body area and by lift, including the knee.

What stays, in most cases, is everything above the knee and everything on the other leg. Deadlifts, hip thrusts, upper body work and single leg work on the good side are rarely the problem. If your home exercise program, your HEP, has a curtsy lunge or a crossover step up in it, that is worth a message to whoever wrote it, not a decision you make alone.

Running, hills and camber

Downhill running is the one almost everybody with this condition can name, and there is a reason it keeps coming up. Geisler (2021) lists hill running, downhill especially, and banked or cambered running among the common findings in the history, alongside a sudden rise in training volume.

Camber is worth explaining because it is invisible. Most roads slope toward the gutter so that water drains off. Run on the same side of the same road every day and one leg lands slightly lower than the other on every stride, which tips the pelvis and puts that hip into a little more adduction for mile after mile. The fix costs nothing: change sides, change routes, or use a track or a flat path while the knee is sore.

Stairs and steep descents on a trail do the same thing as a downhill road, only more so, and they are usually the last thing to come back, not the first. Knee pain when squatting and outer knee pain cover what else can produce pain on descent, because IT band syndrome is not the only candidate.

When you do build back up, do it on flat ground and by time rather than by feel. The return to running plan sets out how, and stage 4 of the IT band syndrome program carries the checks that come before any impact work. Running and jogging also load the joints, the bones and the pelvic floor. Running is impact work, so if you have osteoporosis or have had a fall in the past year, ask your physio before you start. With a heart condition or high blood pressure, check with your doctor before you start.

If you have had a hip or knee replacement, get the go-ahead from your surgeon before you try running or jogging. Many surgeons advise against running and jogging after a joint replacement for good, not just for the first months, because each step sends impact through the new joint. If you are pregnant, have had a baby in the past year, or you leak urine when you jog, jump, cough or sneeze, check with your midwife or physio before you start. Stop and speak to your physio if urine leaks while you are jogging, or if you feel pressure or heaviness low in your pelvis. After having a baby, postnatal guidance usually leaves running and jogging until at least 3 months after the birth, once a pelvic floor check shows you are ready.

The stair machine, the rowing machine and the bike

People switch to these three in good faith when they stop running, which is why they need naming.

Geisler (2021) is specific about it. During the calming period, running-based patients should be cautioned not to use the stair stepper, the stationary bicycle or the rowing ergometer, because each of them keeps cycling the knee through the range that provokes. He suggests swimming and flat ground walking with shorter strides instead. It is worth being clear about what kind of advice that is: it is his clinical recommendation rather than a finding from a trial.

For cyclists the answer is less tidy, because cycling may be the thing you are trying to get back to rather than the thing you switched to. Saddle height, cleat position and how far the knee travels inward at the top of the pedal stroke all change the picture, and the bike fit section of the IT band syndrome program covers that.

Swimming is the safest substitute on this list, and Geisler names it as one of the two he suggests instead. One caveat is worth naming, as reasoning rather than as a finding: a hard breaststroke kick bends the knee and takes the hip out and in repeatedly, so front crawl with a straighter leg is the easier choice while the knee is sore.

Should you stretch or foam roll it?

Stretch it, no. Roll it if it feels good, as an extra, and never instead of the strength work.

The honest reason is that the band does not behave like a muscle. Falvey and colleagues (2010) measured what three common stretches did to the band in donated bodies and found it lengthened by less than 0.5%, and Pepper and colleagues (2021) randomized 30 healthy adults to a single session of foam rolling or stretching and found no change in band stiffness afterward. Geisler (2021) goes a step further and recommends that stretching and deep friction massage of the lower band be left out of the treatment plan altogether.

That does not make a roller useless. Plenty of people find the outer thigh feels easier after a slow pass, and if it helps you train, use it. Keep off the bony point at the side of the hip, stop above the knee, and never roll over an area that is painful, swollen or bruised. IT band foam rolling shows the position and the limits, and the full evidence section on rolling and stretching sits on the IT band syndrome program.

If you have a clotting or bleeding disorder, take blood-thinning medicine, have varicose veins, or have ever had a blood clot in the leg, check with your doctor or physio before you use a roller on it. Do not roll a leg that shows any of the blood clot signs in the warning list on this page. Get medical advice the same day, and call emergency services if you are also short of breath or have chest pain.

What to do instead, and in what order

Start where the knee barely bends and the hip does the work.

Two checks come before any of the exercises below. After a knee fracture or knee surgery, including a knee replacement, follow your surgeon's or physio's plan, and start these exercises only when they have cleared you. If you have had a hip replacement, get the go-ahead from your surgeon or physio before you try these exercises. Several of them take the leg out to the side or across the body, and many surgeons ask you to avoid that for the first months after some operations.

One more check belongs here, because the second block has you standing on one leg. A knee that gives way under you is a same day item on the warning list below. Until it has been checked, leave out the exercises you do standing on one leg, hold the rail on stairs and take care on uneven ground, because a knee that gives way without warning is how people fall.

The last check is about who these are written for. This page is for adults and for teenagers aged 16 and over. Younger children with knee pain should be assessed by a physio or doctor before starting any program, and a teenager who is still growing and has a limp, or pain in the hip, groin or thigh as well as the knee, has a same day line on the warning list below.

Pregnancy changes the first block, because it has you lying down. If you are pregnant, check with your midwife, doctor or physio before starting new exercises. If you are pregnant and past the first three months, check with your physio before exercising flat on your back. The glute bridge in the first block is that position.

The first block is side lying and lying work: clamshell, side lying hip abduction and glute bridge. Many programs start these at 2 to 3 sets of 10 to 15, once or twice a day, and your physio will adjust this. Keep them pain free at the outside of the knee; a tired ache in the hip and buttock is the point.

The second block puts you upright but keeps the knee out of deep bend: lateral band walk and, once that is easy, step up on a low step. Pelvis level, knee tracking over the second toe rather than drifting in. For those two, mild discomfort at the outside of the knee, up to about 3 out of 10, is acceptable if it settles soon after and is no worse the next morning, which is the ceiling the program uses for the same exercises. Then controlled single leg loading such as the lateral step down with band, which belongs late in the program and not early, and by that point the program asks for sessions that are pain free at the outside of the knee rather than for a ceiling.

The staged version, with the doses and the gates between stages, sits on the IT band syndrome program, not here: the order and the gates are what make it a program instead of a list.

How do you know an exercise was too much?

The next morning tells you, and nothing else does.

The rule most physios use for this condition is simple. Mild discomfort at the outside of the knee during or after a session is acceptable if it settles soon afterward and the knee is no worse when you get out of bed the following day. A knee that is sorer, stiffer or more swollen the next morning means the session was too much, whatever it felt like at the time. The pain monitoring model guide sets out how to use that over a week rather than a single day.

Two other signals matter more than how much it hurts. The first is when in a run or a ride the pain arrives: later in the session each week is progress, earlier each week is not. The second is what else the knee is doing, and that is a different question entirely. Swelling, locking, catching, giving way or painful clicking are not training feedback, and each has its own line in the warning list below.

What to leave out if you have had knee surgery

If you have had an operation on this knee, follow the program your surgeon and physio gave you instead of this one.

That matters more here than anywhere else on the page. An avoid list is exactly what someone recovering from an operation goes looking for, and the list above is written for a knee that has never been opened. The caps a surgical team sets are specific and timed, and several exercises named above go straight past them.

After a meniscus repair, surgeons commonly cap how far the knee may bend and how much weight may go through the leg. What is not standard is the size of either cap or how long it runs. A systematic review of protocols after isolated meniscal repair found significant variation between surgeons and no consensus on the weight bearing or the range of movement (O'Donnell and colleagues, 2017), and where a repair was done in the same operation as a ligament reconstruction, most of the studies in a 2025 review held the knee inside a right angle for 4 to 6 weeks and kept weight off the leg or partly off it for anywhere from 2 to 12 weeks (Benelli and colleagues, 2025).

The step up, the lateral step down and the mini squat go past both of those caps, so they stay out until your surgeon or physio lifts the limits. Do not read a few quiet weeks as the limits having expired: the timetable after a repair is counted in months, and 14 of the 18 studies in a second review put return to sport at 3 to 6 months (Harput and colleagues, 2020).

After a trim rather than a repair there are usually fewer restrictions, but the only people who can tell you which operation you had are the ones who did it, and if you had a repair and a reconstruction in the same operation, it is usually the repair that sets the longer limits.

After a ligament reconstruction, the limits also cover twisting and single leg loading, and they change month by month to a timetable you were given rather than one you judge by feel. After a lateral release, the restrictions are the surgeon's own and vary more than the others, so there is no general rule worth printing. That is not the same as there being no restrictions, and the bend, the weight and the date each of them changes are a phone call to the team who operated.

One thing belongs to a lateral release reader on its own account, because that operation divides tissue at the outer side of the kneecap deliberately. A review of 7 studies and 404 patients who had a release or a lateral lengthening for pain rather than for instability found the commonest complications were bleeding into the joint, the kneecap becoming unstable toward the inner side, and scarring, and the instability was more likely after a release than after a lengthening (Feingold and colleagues, 2026). So a kneecap that starts shifting, catching or giving way after a lateral release, and a knee that swells or stiffens instead of settling, go back to the team who operated rather than into a strengthening program.

Three practical points apply to all of them. If you no longer have your instructions, ring the team who operated rather than working from a program written for a knee that has not been operated on, including this one. After hip or knee surgery, wait until your surgical team says it is fine to lie on that side and put pressure on the leg, which gates the side lying block and the foam roller. If you have had a hip replacement or other hip surgery, get the go-ahead from your surgeon or physio before you try these exercises. Several of them take the leg out to the side or across the body, and many surgeons ask you to avoid that for the first months after some operations.

Impact is the one restriction that is not temporary. Many surgeons advise against running and jogging after a joint replacement for good, not just for the first months, because each step sends impact through the new joint. So on a replaced knee or hip, the downhill running section of this page is not a staging question but a conversation with your surgeon about whether running is on the table at all.

Four patterns in an operated knee are urgent rather than something to train around, and all four are in the warning list below. A wound that is oozing or leaking, or a knee getting more tender, swollen, red or painful instead of less, can be an infection in the wound or the joint. A calf or thigh that is newly swollen or getting more swollen, warm or tender can be a clot. A knee that locks, catches, gives way again or pops after an operation on the meniscus can be a repair that has come apart before the tear healed. And on a replaced knee, a fall or even a small knock that leaves the knee newly painful, swollen or bruised can be a break in the bone around the implant, which is the one you may still be able to walk on, so it means stopping the exercises, keeping your weight off that leg and ringing the surgical team the same day. None of those waits for your next physio appointment.

When to see a physio

Some situations are worth an appointment instead of more reading.

The knee is no better after a few weeks of sensible loading, which is also where the NHS puts knee pain that has not improved in a few weeks. You cannot tell which of the structures at the outside of the knee is the sore one, in which case outer knee pain sets out what else sits there. Or you have a program and it has stalled, which usually means a dose problem and not a wrong exercise.

One question cannot be answered from a page, and an assessment answers it in minutes. Which exercises to turn down depends on what your knee does under load and on which stage you are actually at, and both of those need someone watching you move. A physio or physical therapist can also sort out whether the pain is coming from the knee at all: the IT band syndrome program notes that the Ober test has been advised against as part of the diagnosis (Geisler 2021), which is a reminder that even the clinical tests for this condition have limits.

If your pain is further up, at the bony point of the hip rather than the outside of the knee, the avoid list is a different one, and exercises to avoid with outer hip pain is the page for it. Grimaldi and colleagues (2015) describe excessive hip adduction as central to the tendon problem at the hip too, which is why the two lists overlap and why knowing which end is sore changes what you turn down.

Related exercise programs

Warning signs

Get emergency help now

Emergency: pain, tingling, numbness or weakness in both legs, numbness or altered feeling around your genitals or bottom, or new trouble peeing or controlling your bladder or bowels. The same applies if you lose feeling in one leg. Call emergency services or go to an emergency department straight away. These can be signs of pressure on the nerves at the base of the spine (cauda equina syndrome).
Emergency: the knee has moved out of place, looks misshapen or is pointing at an odd angle, or you have tingling or no feeling in the knee, leg or toes, or your foot turns cold, pale or blue. Go to an emergency department straight away. Do not drive yourself: ask someone to drive you or call an ambulance.
Emergency: the knee became very swollen very quickly, within a few hours of a twist, fall or blow, or you felt a pop or snap. Go to an emergency department straight away. Do not drive yourself: ask someone to drive you or call an ambulance.
Emergency: you have had a knee replacement and, after a fall or a knock, you cannot put weight on the leg, your knee or thigh is very painful, or the leg looks out of shape or shorter than the other. Go to an emergency department straight away, and do not drive yourself. If you cannot get up, call emergency services. A broken bone around a knee replacement is rare, but it needs treatment in hospital. If a smaller fall or knock leaves the knee newly painful, swollen or bruised, even if you can still walk on it and the leg looks normal, stop the exercises, go back to your crutches or sticks and keep your full weight off that leg, and get it checked by your surgical team the same day. A break in the bone around a new knee is not always obvious at first, and walking normally on one can move the broken ends apart.
Emergency: you are still growing and have pain that wakes you at night, pain at rest that keeps getting worse, or a lump or swelling around the knee or thigh that keeps growing. If you also have a rash that does not fade when you press it, call emergency services or go to an emergency department.

Get help today

Same day: the pain started with a fall, a twist or a blow to the knee, and now the knee is very painful or swollen, or you cannot put weight on the leg or move the knee. Get medical advice the same day, and go to an emergency department if the pain is severe. This points to an injury, not IT band syndrome.
Same day: the knee swells up, locks so you cannot straighten it, gives way under you, or clicks painfully. These can be signs of a problem inside the joint, such as a torn meniscus (the cartilage cushion in the knee) or a ligament injury. Get medical advice the same day and stop running and riding until it has been checked.
Same day: since an operation on your meniscus, the knee locks, catches or gives way again, or you feel a pop or a shift inside it, or it swells up or becomes much more painful after a twist, a kneel or a deep bend. Keep your weight off it and contact your surgical team, or get assessed the same day at urgent care or an emergency department. A repair can come apart before the tear has healed, and a trimmed meniscus can tear again. If the knee is only a little achy after a busy day, with no swelling and no catching, it is not an emergency, but tell your physio or surgeon in the next few days.
Same day: you cannot walk or put weight on the leg, whether or not there was a fall or injury, or you have very bad knee pain after a fall or injury, or very bad knee pain that came on suddenly with no injury at all. Get medical advice the same day.
Same day: the knee is hot, red and swollen, or you have knee pain with a high temperature or feel hot, cold or shivery. Get medical advice the same day, and go to an emergency department if you feel very unwell. This can be a sign of infection in the joint, which needs treatment quickly.
Same day: since your operation, your wound is oozing, leaking or has pus coming out of it, or its edges start to come apart, or your knee is tender, swollen, painful or red and it is not getting better or is getting worse, or you have a high temperature or feel hot and cold or shivery. Redness can be harder to see on brown or black skin. Contact your surgical team the same day, or get urgent medical advice if you cannot reach them. These can be signs of an infection in the wound or the knee joint. If you feel very unwell, go to an emergency department. If you have a very high or very low temperature, shivering you cannot control, you are breathing very fast or finding it hard to breathe, you are confused or your speech is slurred, your skin, lips or tongue look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or you have a rash that does not fade when you press it, call emergency services, as this can be sepsis.
Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
Same day: you are a teenager who is still growing and you have a limp, or pain in the hip, groin or thigh as well as the knee. Get an urgent appointment with a doctor the same day, and stay off sport and these exercises until you have been checked. If you cannot put weight on the leg, have a high temperature or feel very unwell, go to an emergency department. Some hip problems in growing teenagers, such as a slipped growth plate at the top of the thigh bone (slipped capital femoral epiphysis), are felt in the knee and need checking quickly.
Same day: pain at night or at rest that keeps getting worse. If you are being treated for cancer now, contact your cancer team the same day.

Book an appointment

Within a day or two: you are still growing and have pain that wakes you at night, pain at rest that keeps getting worse, or a lump or swelling around the knee or thigh that keeps growing. See a doctor within a day or two. Ask for an urgent appointment rather than the next routine one, and say what the pain does at night and whether a lump is getting bigger. Do the same if the pain comes with looking pale, unusual tiredness, fevers with no clear cause, bruising or bleeding easily, or weight loss. Bone pain that is worse at night, or a new lump, needs checking to rule out rarer causes such as a bone tumor or a blood cancer (leukemia).
Within a day or two: pain at night or at rest that keeps getting worse. If you have had cancer, now or in the past, see your doctor sooner, within a day or two, and mention it, even if the pain is not getting worse. Do the same if you have knee pain and are losing weight without trying, even if it does not hurt at night.
Within a few days: pain at night or at rest that keeps getting worse. See your doctor within a few days.
Within 2 weeks: pain that spreads from your lower back or buttock down the outside of the thigh or below the knee, especially with numbness, tingling or pins and needles in the leg or foot. The pain may be coming from your back rather than the knee. Book an appointment with a doctor or physio. If your leg or foot is getting weaker, for example your foot drags, catches on the ground or slaps down when you walk (foot drop), get medical advice the same day, and if the weakness is getting worse by the hour, go to an emergency department.

Common questions

What aggravates IT band syndrome?

Repetition through a bent knee, and a leg that keeps drifting inward while you load it. Fairclough and colleagues (2006) measured the band pressed against the bony bump at the outside of the knee at about 30 degrees of bend, so the movements that cycle in and out of that angle hundreds of times are the ones people notice: running, especially downhill or on a cambered road, cycling, stair machines and rowing. Noehren and colleagues (2007) followed healthy female recreational runners for two years, and the 18 who went on to develop the condition had started with greater peak hip adduction and knee internal rotation than matched controls, which is the thigh falling inward as the foot lands. A sudden jump in training volume sits behind a lot of first episodes. Sitting with your legs crossed for hours is the other one people are surprised by, and sitting and crossing your legs covers the position itself.

Can I run with IT band syndrome?

Sometimes, at a distance and on a surface that leaves the knee no worse the next morning, and not at all while it hurts inside the first few minutes of every run. Geisler (2021) describes a calming period first, and it goes further than most people expect: for running-based patients he also cautions against the stair stepper, the stationary bicycle and the rowing ergometer in that window, suggesting swimming and flat walking with shorter strides instead. That cross-training advice is his clinical recommendation rather than a trial result, so treat it as a sensible starting point and not a law. The IT band syndrome program sets out how far to cut back and what tells you it is settling, and the return to running plan covers building back up.

What should you avoid with IT band syndrome?

Four things, in the order they come up most often in clinic. Loaded repetition through about 30 degrees of knee bend, which covers deep squats done for high reps, step ups and downs, the leg extension machine, the stair machine and the rowing machine. Any position that lets the working leg cross the midline, which rules out the curtsy lunge and the crossover step up and is also why the standing IT band stretch is left out of our program. Downhill running and running on the same camber every day. And the habit of pushing through pain that is already there in the first kilometer, which is the one that turns three bad weeks into three bad months.

Are there exercises to avoid with a tight IT band?

The tight feeling and the painful knee are not the same problem, and the exercises worth avoiding are chosen for the knee. Nothing you can do makes the band itself longer. Falvey and colleagues (2010) measured strain in donated bodies and found the band lengthened by less than 0.5% under the usual stretches, and Pepper and colleagues (2021) found no change in its stiffness in 30 healthy adults after a single session of foam rolling or stretching. So a tight outer thigh is not a reason to stretch harder, and it is not a reason to stop loading the hip either. What it is worth avoiding is the standing stretch where you cross one leg behind the other and lean, because that is the adduction position, and Pepper's group measured higher stiffness in the lower part of the band in 10 degrees of hip adduction.

References

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Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin M. The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. Journal of Anatomy. 2006;208(3):309-316. https://doi.org/10.1111/j.1469-7580.2006.00531.x
Muhle C, Ahn JM, Yeh L, Bergman GA, Boutin RD, Schweitzer M, Jacobson JA, Haghighi P, Trudell DJ, Resnick D. Iliotibial band friction syndrome: MR imaging findings in 16 patients and MR arthrographic study of six cadaveric knees. Radiology. 1999;212(1):103-110. https://doi.org/10.1148/radiology.212.1.r99jl29103
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Written and checked by the PocketPhysio editorial team. Last updated 2026-10-21.

This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.