Best Running Shoes for Iliotibial Band Syndrome (ITBS) Knee Problems

Many a runner with a "bad" knee knows about iliotibial band syndrome (ITBS). This chronic inflammation condition affecting the IT band, as it's often called, is sometimes the hidden culprit in exterior knee pain rather than the knee itself.

Footwear often plays a part in its treatment. Iliotibial band problems often afflict:

• women
• long-time or long-distance runners, and
• athletes who've changed something recently - like increasing the intensity or distance of their workout, running on new kinds of terrain, or switching shoes.

Symptoms of ITBS can worsen gradually or appear fairly suddenly after a long spell of "silent" overuse and can last up to six months.

Many runners get rid of the pain with conservative treatments such as:

• easing up on the sport
• doing stretches and exercises
• minimizing downhill and uneven bank running
• alternating direction during the run so as to prevent the knee turning in too much
• adjusting running form
• taking anti-inflammatory medicine
• replacing old, worn-out athletic shoes with new shoes that offer correct support and cushioning.

Only rarely is surgery called for.

Since I once had pain diagnosed as iliotibial band tightness, I researched the topic extensively and found running shoes that were reported by users as helpful for IT band syndrome. I've listed them here.

Signs of IT Band Syndrome

According to the National Institute of Arthritis and Muskuloskeletal and Skin Diseases, runners may recognize iliotibial band syndrome by:

• a popping feeling when straightening a bent knee
• an aching, burning or stinging felt on the outside of the knee that may travel up the thigh - usually during, says Doctor of Podiatric Medicine Stephen Pribut, the latter half of a run, with the pain manifesting itself right above or below the knee
• a swelling (sometimes)

Note: With ITBS, there should be full range of motion.

A Runner's World interview with orthopedic surgeon Dr. Freddie H. Fu offers a useful tip for runners - if you bend your knee at a 45 degree angle, you'll notice external knee pain, a sign of iliotibial band syndrome.

Who am I?

I'm not a doctor, or even a runner any more (and when I was, my highest distance was five miles). I'm just someone who has had chronic foot, back, and knee problems who was also diagnosed with a tight iliotibial band. So for authoritative advice, consult your orthopedic surgeon, physical therapist or sports medicine doctor.

Years ago, I was told by an orthopedist that the source of my back pain was a tight iliotibial band. It turns out they were wrong - the source turned out to be a genetic problem with my spine - but it sparked my interest in the iliotibial band, that thick ligament that runs along the outside of the thigh, connecting to bone at the hip and below the knee, the shinbone. For years, mine was painfully tender to the touch. When I started having knee pain, I wondered if it could be because of a tight iliotibial band.

I learned that when this band rubs (or compresses - Dr. Pribut discusses the debate over whether friction or compression is really the problem) the knee bone where it narrows over the lateral femoral epicondyle, inflammation and pain in the knee bursa or ligament along the outside of the knee can occur.

Well, my pain was on the inside of the knee, and I had none of the classic signs of the syndrome. The knee improved, so ultimately I don't think it was an iliotibial band problem. But it got me researching the topic, and I discovered that a lot of serious runners had knee problems that were down to the IT band.

I would like to mention one more thing in regards to my IT band tenderness. After doing a special kind of massage therapy on myself and with the help of my husband, that area is no longer tender or painful to the touch. Though below in this article I do answer the question of which footwear can help, I am a now a STRONG BELIEVER in using this sort of therapy at least as an adjunct to treating ITBS pain.

Know Your Feet

All the research I did led me to one clear conclusion: you should get your gait assessed by a sports medicine professional to find the right shoe for YOUR iliotibial band syndrome. Unless you know your particular foot irregularities, you could be buying and exchanging shoe after shoe before getting the right style that feels good and lets you get back into running.

That's because unlike in certain other musculoskeletal conditions, such as plantar fasiicits (which I have), runners who get ITBS don't primarily follow one profile. They may have high arches or low/flat arches. They may be underpronators or overpronators. They may have a completely normal arch and gait. There is simply no one shoe that fits all, because the syndrome has multiple causes and risk factors.

So please do this first! Recommendations are all well and good, but only once you know your stride irregularities should you then pick out your shoe to try.

Short List of Athletic Footwear

This is the short list. The long list is about the size of a bible, because, well, whatever shoe works, works. I picked these models because reviewers specifically liked them for iliotibial band syndrome. Treat them as a starting point and do your own exploration after you know your gait.

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1) The Saucony  Triumph ISO3 (paid link) is extremely cushiony. Saucony is a popular brand overall for people with foot problems.The Triumph ISO is a neutral shoe with lots of cushioning and may help people with oversupination and/or high arches. Neutral shoes don't push your feet into committing to any one stride, as stabilizing shoes do. Instead, they allow for increased flexibility of foot motion and so are great for athletes with rigid feet. More than one person has reported their ITB knee problems were helped by this shoe.

2) I've worn my share of Brooks shoes for running and I've found them to be very well built and comfortable. The Brooks Men's Defyance Running Shoe (paid link) is a neutral running shoe built for an average arch that also offers some stability, so may suit mild oversupinators and mild overpronators. This footwear does not feature maximum cushioning - in fact, cushioning looks like a weak point - so may be more suitable to cyclists or hikers (both of whom are also prone to getting ITBS) or those who wear cushioned insoles. I'm sorry to note here that the Defyance may have been discontinued.

3) The Hoka One One Bondi (paid link) is big on cushioning and was reported to help at least one runner with ITBS. Another runner with ITB pain, who goes by the username ParaDoX667, reported on this reddit thread that Hoka shoes have helped him.

4) The Mizuno Men's Wave Creation 14 Running Shoe (paid link) appears to have helped one older user with "extensive" knee problems and ITBS.

5) Though I can't find a reference to the iliotibial band in this shoe, the ASICS Men's GEL-Cumulus 12 Running Shoe (paid link) does have a number of reports of helping people with knee pain of unspecified origin. Again, this one is a neutral shoe with cushioning as its primary feature, built primarily for people who underpronate, although it also may work for mild overpronators.  Note that different versions of this shoe have different sizes of toe box.

Respect the Shoes

Here's a basic tip you can apply right away: Long-distance runners and heavy athletes are especially prone to wearing out the cushioning of shoes quickly, but continuing to use them because they still look fine on the outside. To prevent further occurrences of ITBS:

• Replace your running shoes frequently
• Let your shoes rest at least a day after a workout to restore their cushioning (you may need to keep two pairs on hand).

What is Your Story?

If you have ITBS, I'd love to hear about the shoes you used, loved, hated, and what therapies helped you. Leave a comment and take the poll.