IT band syndrome can be scary but it's good they identified it correctly because it can easily be confused with other conditions associated with runner's knee. The most important thing, as has been pointed out already, is rest for at least 8 weeks. Easing yourself back into cycling first, as other's have said, is also important because it's low impact can help with rehab of the knee and IT band. All the best for your recovery mate and remember to take it easy

I'm two weeks into cycling again, which merely consists of once a week for 30 minutes at low power and high cadence. So far so good.

I'm a sports massage therapist, have worked on many runners with ITBS. I saw a runner for the first time 10 days ago, training for a mid Oct marathon but had given up hope of racing because he couldn't run more than 5k before having to stop in pain. I told him to not give up on that marathon just yet. 2 days after working on him he ran 22k with soreness just starting in the last 2k. Another treatment followed shortly after, then 3 days later he raced a half marathon with no pain. He's back on schedule to run the marathon with a goal to finish. He had done physio with 2 different physios over a few weeks, but was getting nowhere. Despite what you sometimes read about ITBS, sometimes there needs to be really deep work done, not even necessarily with the ITB, but primarly the lateral quad, glutes, and TFL. The strength work and working on imbalances is essential to long term healthy running. But getting through the acute pain phase and running injury free should not take months! I would highly recommend seeking out a massage therapist who is experienced with deep tissue work with athletes.

Can you elaborate a bit more as to what the massage addresses? I've thought about having some active release and massage done but never took the time to schedule anything. I think I've done a good job with the strengthening but still feel "twinges" every now and then that tell me there is still some tightness that could be lingering. Really appreciate the reply, btw.

ITB issues are often the accumulation of tightness throughout the whole upper leg, glutes, TFL, and lateral quad. It's not necessarily a "friction" issue, as often described, that creates the lateral knee pain. The primary issue is often with the ITB adhering to the underlying quad muscle. So where the ITB is supposed to glide freely over the quads, there is no free movement when the ITB gets adhered. This adherence can be as far down as the lateral knee. With my recent client the most affected areas that i addressed were the upper part of the lateral quad, just below the greater trochanter at the side of the hip, and the tissue at the lateral and front aspect of the knee. Again, the effect of this was immediate. Self massage can help, but you can't get the same amount of depth and be as specific as a therapist. Using a rolling ball and trying to work under the back edge of the ITB, where there is a defining ridge, is very helpful.
Keep up all the strength work and address any imbalances, and keep this up... like forever. But the deep work will address the acute issue.

I had mild ITBS symptoms with lateral knee pain as well for a while in my left knee, but not my right knee. The only real difference is my left foot is somewhat flat compared to the right, and my foot and ankle was collapsing a bit on the downstroke, causing my knee to also collapse to the inside a bit. I also had a similar issue with running as well. I got a couple of cleat wedges and built up the inner side of the cleat so my foot / ankle would be more supported and my knee would stop collapsing inward when I rode. I also have to get very supportive shoes and insoles to assist with keeping my ankle from collapsing in so much. None of this may resonate with you, but figured I'd throw it out there just in case!

I struggle(d) with this similar problem and the thing that helped me get to the point where I could start running again and actually work on the strengthening was that I found a person who specialized in dry needling. This doctor is a PT and a certified acupunturist who understands how the body moves better than anyone I've ever met before. It sounds like you are in TX, and every state has different laws pertaining to who can dry needle. I live in NJ, and PT's aren't allowed to do it, but this doc is in NY. She got these permanently tight muscles to release, which allowed everything to move the way it's supposed to and that allowed me to then strengthen everything. If you can find someone local who is well regarded, this might be a worthwhile option.

---

USAT Level 1 Coach
Team Next Level
http://goteamnltri.com/

Did you also get ART or massage? I've started going at least weekly to get this done in the hopes it keeps things moving around the IT band, along with keeping the hip, glute and TFL muscles loose.

Have you had a bio-mechanical eval done by your PT? I had bad ITBS starting in late 2019. Tried PT and 3-4 months rest, immediate flare up. Thanks to COVID I took the opportunity and tried resting and strengthening…for over 8 Months. Started running and boom 20 minutes in it flared up again. Tried a different PT and rested again for almost 4 months, same issue on first run back. Turns out I had developed a slight cross-over with my right leg which my (third) PT noticed in June 2021 when he got me on their treadmill with the impact sensors etc... His theory was that extra extension and load of the leg being over the midline was casing the ITB to pull on the knee more than it should.

Worked a on stretching and strength to deal with the short term pain, but changing my form and to remove the cross-over has been the solution for me (no pain since July last year). Was able to build up volume this year to the highest I’ve ever had during HIM training at about 30mi/week avg with a 10-14mi long run and still no issues. Also never had an issue cycling strangely enough, even after a running induced flare-up.

I’ve had some analysis done and all signs pointed to very weak hips/glutes. I also have a slight increased Q-angle on my right side which probably added juuust enough extra tension on the IT band for that to become the injured side. This is the first time since being injured in February that I've actually took a lot of time off, three months so far. I even stopped cycling because that was painful as well, but probably because the running made it extremely inflamed.

I’m hopeful the root cause has been addressed. The pain originally started at a time when I was ramping up the run volume and intensity too much, and doing so in the winter without a proper warmup. Recipe for disaster with weak hip muscles. I have a long history of running and have never had IT band issues until this year.