IT band syndrome has a frustrating habit of showing up at the same point in every run. It is a pattern we know well at ActiveX Physio in Singapore: the outside of the knee tightens, then burns, then makes the decision for you. If you have been foam rolling it religiously and wondering why it keeps coming back, there is a reason.
Why isn't foam rolling fixing my IT band?
Most people go after the IT band directly: rolling it, stretching it, waiting for the release. The IT band is a thick sheet of fascia, and rolling it changes its length about as much as rolling a seatbelt would. What decides how hard it gets pulled is the muscle upstream, the gluteus medius. When the hip is not stabilizing the pelvis through single-leg stance, and running is single-leg stance, stride after stride, the band picks up the slack and gets overloaded. We assess hip and glute function through single-leg patterns, watch pelvic control while you run, and go after the weakness that is making the band compensate.
What fixes IT band syndrome?
Treatment centres on lateral hip stability. Single-leg squats and lateral step-downs are the foundation, with targeted gluteus medius strengthening layered underneath and progressed as the hip gets stronger. We also watch your running mechanics under fatigue, because a pattern that holds for the first easy kilometer and collapses in the last one has not actually changed. If the band is particularly irritated, we settle the acute symptoms alongside the strength work so you can keep moving while the hip catches up. Rolling can stay in your warm-up if you like how it feels; it just cannot be the plan.
Who can help
Any of our physiotherapists can assess and treat IT band syndrome. If you are a distance runner, Nicholas Ho works with endurance athletes and can assess your hip stability, pelvic control, and running mechanics. If your running sits alongside functional fitness or Hyrox, Isabelle Chow sees this combination regularly.
Go deeper
Our guide for endurance athletes covers IT band syndrome alongside runner's knee and the role of hip strength in keeping runners on the road. Read the full guide for runners →