I am not a medical doctor.
I have no evidence that the following will work outside my N=2 story.
Chat with a medical professional.
Consider the following story purely discussion of personal anecdote, and not exercise, diet, or medical advice.

Story:
My non-science-interested buddy (salesman in tech industry) told me that his doctor prescribed high-dose anti-inflammatory meds for a week. 3 x 800mg ibuprofen daily for 7 days. He said it worked like a charm. He resorted to this only after months of therapy with no results.

I was skeptical, but was dealing with IT band pain that wouldn't relent even with substantially reduced training load and light PT. I had indomethacin (an anti-inflammatory medicine) laying around from an old back injury. It's a 12-hr pill... I think (again, see: not an MD!). I took it for 36 hrs and was healed, permanently, after 48 hrs. IT band pain never returned, even with rapidly increased training volume.
End story.

Lateral hip and hip flexor strength, and modulating overall training load to not-too-far exceed current abilities is probably a good idea. :)

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Dr. Alex Harrison | Founder & CEO | Sport Physiology & Performance PhD
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Wow I'd consider myself lucky if I were you. Maybe I'll give that a try next time my IT band inevitably flares up. I've dealt with IT band issues twice (once in each knee). In both cases I went to physical therapy, did all of the core/glute strengthening exercises, etc. I hate to say it but the only thing that "healed" me was taking 6 weeks off running. I wasted lots of time hoping that a week or two of rest would cure things only to go for a run and re-aggravate the injury.

FWIW here is a sampling of the regimen the PT had me on during the break from running.

Side step squats w/ band
On bosu ball - single leg kick outs w/ band (both out to side as well as straight back)
Hip thrusts w/ weight bar on lap
Quad leans
Hamstring curls

Hopefully that helps, ITBS sucks and I feel your pain. Best of luck with your recovery!

I know this pain. I've had recurring ITBS in both knees at the end of the season for the past two years. I've tried stretching, braces, creams, foam rolling, lunges, several pairs of shoes, gait changes, increased strike cadence. Prior to the issue I would frequently do 25 mile+ weeks with no issues/pain though it seems the volume caught up to me somewhere.

As has been said the only thing that worked for me was 8 weeks+ off which is really hard and no guarantee. I have tried taking just 4 or 6 weeks off and it never fully "heals". I am still swimming indoors, biking a lot on the trainer, lifting weights. My most recent bout with ITBS was in November 2020 and I'm actually afraid to start again for fear that I won't be able to make it 5 miles. Just bought a new pair of sneakers again last week, fingers crossed.

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Nutmeg State

This is something I’ve dealt with periodically for 20 years as mild scoliosis results in slightly twisted hips that results in me leaning slightly to the right towards the outside of my right foot, causing tightness through my right leg and into low back.

The things that have helped me:
1. I don’t skip any “core”, gluteal muscles, stability, mobility, etc. I probably accumulate 2.5 hours of “stuff” related to the area from my gluteal muscles to chest each week.
2. About 9 months ago I started weekly dry needling in my right gluteals which resulted in more mobility through my hips than I’ve had in 10 years, at least . After 3 months of that and getting tired of paying the fee my PT suggested I get a hypervolt and do the same myself - which I’ve done and am still feeling great.

I don’t know if I’ve the combination of the above will permanently help, but I’ve not felt this good in a long time.

I've had ITBS flare up only a few times over the past few years (ranging from can't walk downstairs to only hurts when I run). What fixed it for me was:

2-4 week break from running
Side leg raises, Clamshell exercises, and sidestep exercises - all with bands.
Return to running at a slow progressive pace.

I certainly do! Was very skeptical that it would work in the first place.

And I should have clarified: I returned to high volumes of cycling which I do most frequently. I did return to previous running quickly too, but hadn't been doing much of that anyway. It had been the cycling that initially caused my ITBS and I was able to return to that very quickly. I remain even more skeptical that it might work as well as it did for cycling, had my initial offenses come primarily from running.

Another reason I may have gotten away with it: I came from a place of being very well strength-trained and just needing to work up the endurance capacity of the related musculature. I had recently transitioned from bobsledding to cycling & triathlon.

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Dr. Alex Harrison | Founder & CEO | Sport Physiology & Performance PhD
-------------------------------------------------------------------------------------------------------------------------------------------------
📱 Check out our app → Saturday: Pro Fuel & Hydration, a performance nutrition coach in your pocket.
Join us on YouTube → Saturday Morning | Ride & Run Faster and our growing Saturday User Hub

I’m a doctor and also dealt with IT band syndrome in 2018 which cost me Ironman Louisville. Mine popped up out of nowhere on a Sunday long run in early august (Louisville was mid-October). Couldn’t run again for 6 months. Not what you want to hear but that’s my story. I tried swimming and cycling only, but it just kept lingering. I went to PT, did cupping, dry needling, etc etc. I finally decided in late September I wasn’t doing Louisville and swam only until February 2019. I started with 1’ run and 1’ walk. It hasn’t come back since. But now I’m dealing with Achilles tendinitis 😩

Thanks everyone for the input! The overarching theme seems to be - take a break and strength/mobility for the hip and glues.
Generally trying to stay away from meds as long as I'm not affected in day to day live, but thanks for the input!

Tried running again today but stopped after 15min as the ITB felt "funny". Will do as recommended and not try again until in two weeks time.
I guess that's an early end for my June 50k Trail Race Plans :(.

My son, prepping for college running, hit a high of 9 hours of running last July and then one day said his knee hurt. I was sure it was ITB and had him do a couple of stretches which always worked for me. When that did not helpI google itb helps and came across a website where a guy (I think he was a doctor) had compiled all the annecdotal evidence he could find. YOu had to pay like $19 for it but he warned you he was not going to give some sort of fool-proof plan for recovery. I paid, read the whole thing and came away with the assurance that ITB band problems are not really well documented or researched by modern medicine. He gave a bunch of "try this and see if it helps" but the only sure thing he had observed was that you had to take time off. Even the necessary time off varied from person to person. My son took off most of a month and felt great but ramped up too fast and it came back.
The next time he took about six weeks and how is slowly working his way back into it. he hated it so much that he was willing to be super patient and add only 30 minutes a month.
We are going to go from about 1 hour per week on three runs to one hour per day in about six months time. I hope it works. He is frustrated enough that I think he may quit if it comes back.

Stretching always makes a big difference for me. That is what was recommended to me by our team's physical trainer the first time I experienced ITBS (back when I was playing soccer and had access to a sports medicine department). The pain was so bad I was sure I had torn a ligament. She did all the tests, and told me it was my IT band and that the first step was to do lots of stretching. I was dubious that the solution to something so painful was so simple, but I tried it and sure enough, it gradually went away.

I should clarify that I don't mean stretching directly before or after exercising. I have had the most success when I spend 10-15 minutes every night just stretching to increase general mobility. When I have been diligent about nightly stretching/mobility, I have not had any IT band issues...the only time it has flared up is when I have been slacking on the stretching.

I'd add foam roller, ideally working up to full body weight. 10x up and down per side is minimum maintenance for me. Not right down onto the outer knee, nor up right onto the bursa on the hip, but the rest of it. If you're not used to it, it may take a while to work up to that pressure. Probably wouldn't hurt to include hamstrings, quads, and calves. (This video makes some good points about working the muscles moreso than the tendon itself: https://www.youtube.com/watch?v=jVvUW4SAMuk - I tend to do it more lazily and just roll up and down the outside)

Thanks! Ive been using the foam roller sporadically it always felt good. Will include it into the routine more frequently.

Anything specific? Or just general hip/leg flexibility?

I just do it all to avoid imbalances of some areas being tight while others are more flexible.

Definitely do the ones that common sense says you should do (hamstrings, quads, hip flexors), but I throw in a lot of piriformis, groin, calves for good measure.

I also quite often do a 15-20 minute yoga flow session instead of static stretching. For me, that has the added benefits of 1. Movement, 2. Not having to think about what to do next, and 3. Lower chance of bailing after 5 minutes. If you search "yoga for flexibility" on YouTube you'll find tons that will work great.

Consider having your running form/gait looked at. I had pretty severe ITB issues in both legs, to the point it hurt walking. The strength training, stretching and foam rolling definitely helped get rid of the pain but what I think really made a difference was changing my running form and learning to run with a foot strike underneath my center of gravity as opposed to out in front. It's been around 10 years since I had ITB issues and I run significantly more than I did back then.