Painful Knees and Leg Pain from Running; Tensor Fasciae Latae (TFL) and Iliotibial (IT) Band Syndrome

From our Move with Ease Series, how to take care of your lower body so that you can keep moving with ease for years to come!


Athletes who do a great deal of running are often prone to injuries related to this activity, in large part due to the stress that is placed on the body while running. 


It is also common for those who are running to neglect to  perform proper warm-up and cool-down stretch exercises.


Even with caution and proper stretching, there may be times when an individual is unable to avoid a running-related injury. 


One of the most common injuries which presents itself with runners is iliotibial band syndrome, also called tensor fasciae latae syndrome.


The tensor fasciae latae (TFL) is a tiny muscle which is attached to the iliotibial (IT) band, also known as the fasciae latae.


Fascia is the tough outer layer of the muscle, which gives it structure, protects it from damage, and transmits movement from muscle to bones.


If your muscles are sausages, then the fascia are the sausage casings.  The IT band is the fascia for the muscle that runs up the outside of the thigh, originating at the top of the hip and ending on the outside of the knee.


The main job of the IT Band is for knee extension and flexion and so it is used for walking and running.


LB101_bookAd_CoachPromo@500One of the main symptoms of tensor fasciae latae syndrome is pain on the outside of the knee. This is a symptom which is present in very few conditions, so it is frequently a telltale sign of TFL syndrome.


It is caused by the IT band being pulled too tightly.  This is usually a result of action by one of the two muscles connected to the iliotibial band – the gluteus maximus, or the tensor fasciae latae.


The pain may not be present until part-way through a running session, and typically presents itself when an individual is attempting to climb a hill.  It is sometimes associated with a snapping or clicking sensation in the muscles on the outside of the hip.


One of the best ways to avoid TFL syndrome is to warm-up with a foam roller or The Stick (a runner’s tool). Massage and relieve any tension in the butt and legs (specifically the calves, IT, TFL, and lateral medius-outer thigh muscle) thoroughly before every work-out and run then repeating the action after.


This warm-up method will help keep the muscle and fascia in these regions in optimum working order and aid in injury prevention.  Stretching should be done for cool down, paying attention to stretch the calf, leg, and hip muscles.


When pain and swelling occur in the knees stop any exercise movement and follow the RICE method: Rest, Ice, Compression, and Elevation.


Rest aids in healing and preventing further injury to the area.


Ice helps to reduce the inflammation and pain associated with the injury.


Compression further prevents more swelling- edema that can cause more pain, loss of function, and slowed blood flow from vessel restriction.


Elevation also helps to reduce swelling, increase blood flow return, and removes waste from the area.


TFL syndrome is sometimes related to faulty pelvic mechanics.


If one side of the pelvis is higher than the other, or if the pelvis moves awkwardly while running, it can create a case of iliotibial band syndrome, or aggravate an existing case.


Stretching and massage won’t be enough to correct the problem if this is the case; often, patients who have faulty pelvic mechanics won’t get relief from their TFL syndrome symptoms until they see a chiropractor.  Regardless of the cause of the TFL syndrome, it is important to treat it properly and avoid further injury. When it’s time to return to regular activities, do so slowly and without engaging in strenuous exercise too quickly.


There are a variety of other activities which can help runners stay fit without aggravating their IT band, such as swimming and cycling. It is usually best to stick to these activities until the TFL syndrome is gone.


Seek training advice from a personal trainer or running coach to improve workouts and prevent injury. As with any injury, it’s crucial to seek a doctor’s care if the pain is severe, or if other methods don’t bring relief.


The following exercise images will help stretch and relieve TFL and IT pain. Directly apply pressure on the TFL and IT bands with a foam roller for 30 seconds or longer. Stretching the TFL, IT, and even lower back will offer relief.

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Home Anatomy & Physiology Painful Knees and Leg Pain from Running; Tensor Fasciae Latae (TFL) and Iliotibial (IT) Band Syndrome