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The iliotbial band runs down the side of your leg from your hip to just below your knee. One of the areas where it attaches is the head of the fibula, the smaller of the two major leg bones. That area is most often the source of pain when this band is injured.

One major cause of the ITB injury is too much pronation in the foot and ankle. This happens because the ITB’s attachment to the front and outside portions of the leg tries to give lateral internal rotation of your lower leg. The resultant pain from the ITB’s attempts to resist this excessive motion almost always occurs at the point where this band pulls the biceps femoris muscle, at the head of the fibula.

Another cause of the ITB problems is lack of flexibility in this band, which can be the result of weakness in some hip muscles. Even though fascia has little ability to stretch, the muscles that attach to it, including the big gluteus maximus of your buttocks are able to lengthen.

Because the exercise designed to stretch the ITB is somewhat awkward, very few people incorporate it into their flexibility routines.


Treatment for this condition can include ice, rest from normal activity, acupuncture, dry needling, stretching the traditional way to increase the flexibility of the piriformis muscle gluteal muscles. Also often recommended is use of a foam roller, therapeutic cupping, guasha and strengthening.

Other prevention tactics include modification of the intensity of a training session as well as the use of orthotics and supportive shoes to prevent excessive foot pronation. Also avoid training on hard surfaces.

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