If you’ve got an aching knee or a sore hip, your joints may not be the main source of concern. Active women often suffer what’s known as iliotibial band syndrome, or ITBS, says John Gallucci Jr., P.T., the president and CEO of JAG Physical Therapy in New York. ITBS is an overuse injury that can develop when there is inflammation in the iliotibial band, a line of thick tissue running from the outside of the hip (aka iliac crest), past the knee, and to the top part of the tibia. The IT band stabilizes the outside of the knee, so it gets worked in a variety of activities, whether you’re running, doing lateral leaps, climbing stairs, or lunging for a tennis ball.


Women suffer from ITBS more often because our hip anatomy means the knees tend to turn inward, causing IT tissue to rub against bone, creating inflammation. Runners who put in a lot of mileage are at high risk, as are those who repeatedly run on a banked surface (like the same side of the road) or those who do hill work (especially when you’re running downhill, where your IT band is working extra hard to keep knees stable). Whether you ride outside or in a class, cycling can also cause problems, especially if your foot rotates inward in the pedal, which can increase tension on the IT band. And strength training can take its toll, especially if your routine includes endless sets of squats.


“Patients can feel a dull pain, usually outside the knee or hip, that typically gets worse with activity,” says Derek Ochiai, M.D., a sports medicine physician and an orthopedic surgeon in Arlington, VA. ITBS can also create pain and swelling outside the knee. Unsure if you’re struggling with an injury or just sore after a tough workout? “Soreness after a workout usually resolves by 50-70% in 24 to 48 hours,” Gallucci says. “IT band syndrome has more prolonged symptoms—the inflammation tends to sit in the tendon, so each time you work out the tendon gets tighter, and you’ll feel the pain or discomfort.”