How to address IT band / hip pain?

June 28, 2019 9:19 AM

I have a desk job where I sit all day. I also like to run and road bike. The combination has caused pain in my glutes and the IT band area around the hip (no knee pain). Have you had similar issues, and how did you address it?

I work at home, so there's flexibility in how/when I can move around. A standing desk is not an option (I've tried it and didn't see improvement).

I do yoga a couple times a week and do strengthening exercises for glutes/legs (clams, leg raises, squats). I foam roll on the glutes, hamstrings, and quads, but try to avoid the IT band itself. The number of hours in the chair, it seems, overpowers improvement I see from that work.

The pain has occurred for months (at least since Feb.). When it flares up, I'll rest for a week, see improvement, and then bike 10 miles only to see the pain return.

How can I make this problem go away for good? Do I just need to trust that the exercises/stretching will work eventually? I don't want to lose my level of cardio fitness, but I'm worried pushing through the pain will just make it worse.

posted by mr_bovis to Health & Fitness (10 answers total)

Here's what works for me:
1. Seeing an osteopath for hands-on manipulation during the flares
2. On her advice and the advice of my Pilates teacher, actually strengthening my inner thigh muscles/lower core so those big outer muscles aren't the only ones working
3. Focusing on moving those inner muscles/using lower core for support during exercise (I just did this during a spin class this week and it was amazing how much of a difference it makes)
4. I actually do foam roll my IT band, to me it feels great, but it's sensitive so you have to go slow/carefully. I also love this thing my Pilates teacher showed me literally called "The Stick" which you can buy on Amazon. Less intense than foam rolling but also feels great.
5. I have a sit-stand desk at my office and I do find it helps, but I alternate between sitting and standing throughout the day.

Consider whether stretching your Psoas might help too! Feel better. For me this is an ongoing process.
posted by CiaoMela at 9:29 AM on June 28, 2019

Foam rolling the actual IT band, however painful, is absolutely necessary for me. It does hurt less as you do it consistently!
posted by restless_nomad at 9:41 AM on June 28, 2019 [2 favorites]

I get this at the hip, particularly when I end up working 12-14hr days, and then go for a run (because oh hey need to try to offset that sitting).

Things that sort of help:

1. THE STICK. I actually own two; a long one for home, and a shorter one for travel. I sometimes need help from my SO to roll out the backs of my legs properly, but I find it REALLY helps.
2. Foam rolling after the stick, on the butt, hamstrings, and IT band. (I make a lot of sad noises and both my SO and my cat get quite concerned)
3. Increase my water consumption. On long days I make sure to drink 3+ liters of water or tea; this has the side benefit of making me go to the restroom a bunch, which forces me to move a little more.
4. I stretch focusing on hips and roll when I get home irrespective of if I did any "real" workout. I don't like it, but it does make a big difference.
posted by larthegreat at 9:42 AM on June 28, 2019 [2 favorites]

This kind of pain can be very difficult to consider (let alone properly) over the internet. IT band pain, due to the way legs are built to walk, is a bit of hip-function-warrant-canary; it's presence just tells you something bad is happening.

I am not a medical practitioner, I athletes at a world-record-winning-international-medals level. I strongly suggest seeing a PT for diagnostic information and advice.

In my day-to-day I see this kind of thing due to a host of issues: weak medial glutes and femoral rotation causing over work in the ITs & piriformis, poor posterior chain competency resulting in hamstring/adductor dominated gaits, internal/external hip rotation imbalances, secondary injury (adaptive stress) , poor equipment fitting (in my case prosthetics, AFOs or seating - have you had your bike fitted?).

tl/dr; this kind of pain can come from many causes, see a PT to get detailed advice and information regarding your presentation. Lots of different practitioners will specialize in helping you recover, a PT is mostly likely to be able to give you a clinical, insurable, diagnostic opinion.
posted by mce at 9:44 AM on June 28, 2019 [1 favorite]

Exact same issue, although mine was a combination of running + desk job. What worked for me:

1. Standing desk - it took some time, but it actually made a HUGE difference in the tension I was feeling in my hips and lower back.
2. Physical therapy - just once every two weeks, and also doing the recommended exercises at home or at the gym (ok so I was bad at that part of it, but just seeing the PT a few times helped a tremendous amount). PT also helped me with posture to relieve pressure when sitting at my desk (for example, we think good posture is to shoot straight up, but in my case, it was actually to tuck in my tailbone and curve my lower back to protect it)
3. Foam rolling. Foam rolling. Foam rolling. Before working out. After working out. All the time (foam rolling + the stick). I foam rolled the IT band (as larthegreat says, foam roll the actual IT band - hurts like hell but makes a ton of difference. Also try a lacrosse ball to really dig into the hips and IT bands.
4. Epsom salt baths and/or ice bath after an intense workout
5. Strength training - working with exercise bands to strengthen hips and glutes. Lots of squats and lunges.
posted by something_witty at 9:59 AM on June 28, 2019

Talk to a sports medicine doctor and have them refer you to a PT. Pilates is also a great supplement. (The same answer I give to every AskMe question about hip/knee pain.)
posted by matildaben at 10:08 AM on June 28, 2019

I sometimes have this issue and a few things:

1. I originally thought it was my IT band and glute and it happened to also be my piriformis.
2. Sitting and leaning forward (with my shoulders further forward than mid-thigh) seems to end up hurting it more than sitting up straight in a chair.
3. How I sleep seems to exacerbate the problem. I'm a "super hero position" side sleeper (bottom leg straight and top leg bent). Could this be causing you pain without realizing it?

Hope it feels better (permanently!) soon
posted by whitetigereyes at 10:10 AM on June 28, 2019

I don't think that your hip/glute pain is an IT band thing, as it would cause pain on the outside of the knee. There are a bunch of different things that could cause hip/glute pain; bursa, impingement/tear off the labrum, lumbar issues causing referred pain to the hip, piriformis syndrome, etc etc etc.

If stretching and strengthening efforts have not resulted in improvement, I think it's time to visit a medical professional.
posted by sweetpotato at 10:11 AM on June 28, 2019

I'm currently seeing a PT for some hip issues, including similar pain around the IT band area in the hip (with no associated knee pain). She's having me do core strengthening exercises and some "osteopathy inspired" alignment/stretches at home; in therapy, she's used The Stick mentioned above, along with regular and ultrasound massage.

Going to my primary care doctor for the referral was annoying ("Oh this hurts? Yeah, go see the PT") but definitely worth it.
posted by damayanti at 11:07 AM on June 28, 2019

I don't have any specific help (outside of see a PT), but... Are you resting for a week and then jumping back in with a 10 mile bike ride? I might be reading you wrong. However, if I'm not, then what about slowly ramping things back up?
posted by kathrynm at 4:06 PM on June 28, 2019