Lateral leg pain, more than just the IT Band

In an earlier post, we explained why foam rolling and stretching your IT Band is not the most effective way of getting rid of your IT Band pain. Rather, you should get to the root cause of the pain which is usually due to lack of hip stability, strength, poor motor control, etc.

However, for the sake of this topic, let’s assume you already know this and are working on it. This issue takes time to fix and clean up, and in the meantime you still have lateral knee pain.  It’s important to point out that there are several additional factors that can contribute to IT Band pain and like most injuries, it’s multifactorial. So let’s dive in.   

The Problem: If your pelvis is dropping in single limb stance and your knee is diving inward, you’ll have already irritated the structures that attach to the lateral leg which include the gluteals, hip flexors, and quads. If you irritate them enough, they’ll start talking to you in the form of pain, so you should address these issues while fixing the hips. Knowledge of anatomy is incredibly helpful here to make sense of the mechanics happening in the lateral leg.  These muscles attach and pull on the IT Band. One function of the IT Band is to serve as an anchor point for Gluteal Max/Med/Min, TFL, and Vastus Lateralis.

This is one reason why the IT Band is a steel cable and you can’t stretch it. So stop trying!  As a result, the muscles that surround the IT Band often refer pain along the IT Band when they get irritated and pissed off because of your crappy movement.  (Shame...shame...shame.)  *Notice how the Vastus Lateralis sits right UNDER the IT Band!

Referred pain is often felt during a heart attack.  One of the most common signs is left arm pain. Even though the left arm is perfectly fine, the cardiac muscle is referring pain down the left arm. The problem is the heart muscle not the arm. Skeletal muscles refer in the same manner.

Therefore, referred pain can be traced back to trigger points (irritated muscle fibers) that have specific referral patterns throughout the muscle. Below are IT Band referral pain sites which show how each muscle refers pain and then gets confused with “IT Band pain”. Your IT Band may not be the cause of the pain but simply the site of pain.  This is an important differentiation.

Glute Minimus

Tensor Fascia Lata

Vastus Lateralis

The Fix: To resolve these pain referral symptoms you should attack the problematic muscles NOT the steel cable (in addition to fixing the underlying cause). Keeping the muscles loose - stretching and foam rolling (amongst other treatments strategies) will absolutely resolve trigger points and decrease the referral pain process. So, rather than foam rolling and stretching the site of pain (the IT Band), you should instead release the tension and stress to the muscles that attach onto IT band.

1. Fix your hip issues and crappy movement patterns.

2. Stop stretching and foam rolling your IT band.

3. Start stretching and foam rolling trigger points/muscles that attach to the IT band. In that order.


Here are a few of our favorite soft tissue techniques to help with lateral leg pain.