The IT (iliotibial) Band is a long, tough tendon that is an extension of the Tensor Fasciae Latae (TFL) muscle . The IT Band can cause a lot of pain in the hip and outside of the knee when tight. IT Band pain is common in runners due to the amount of stress placed on the tendon while running.
Tensor Fasciae Latae (TFL) Muscle & IT Band Tendon
IT Band Pain Anatomy
Understanding IT Band pain in the hip begins with understanding the TFL muscle as a whole. The IT Band is the tendon portion of the TFL muscle - in other words, it is the connective tissue that attaches from muscle to bone (see image below for reference). The IT Band itself does not contract and is not a muscle, but rather is an extension and an anchor of a muscle (TFL).
When investigating IT Band pain and tightness, the thick, dense, bulb-like portion of the TFL should be the first suspect. As a tendon, the IT Band portion of the TFL does not vary in length or have room to stretch, but the TFL bulb muscle does. To decrease the painful tension in the IT Band - the tissue in the TFL muscle should be broken up and stretched.
IT Band Pain In Hip Relief
The most effective way to reduce the painful tension in the IT Band is to massage and break up the tissue in the TFL muscle bulb. The IT Band itself can't be massaged or lengthened, but the TFL muscle can. If the IT Band is tight, the TFL muscle is tight, it and likely contains knots and trigger points that need to be worked out.
TFL Muscle & IT Band - Where To Massage
To massage the TFL muscle for IT Band hip pain relief, you will need a tool that can deeply dig into the muscle. Often times a smooth, soft foam roller is not going to do it. A lacrosse ball can work, but a targeted massage tool like QL Claw works best. QL Claw is a tough but pliable material, and has a knuckle-like trigger designed specifically for deep tissue massage in low back, hip, and glute muscles. Its trigger feature was designed to mimic the knuckle and elbow of a massage therapist, and it is perfect for therapeutic relief.
To learn how to relieve IT band hip pain through deep tissue muscle massage, check out the QL Claw being used on the TFL muscle at the end of the article.
QL Claw Device
IT Band Pain Patterns & Symptoms
IT Band pain typically manifests in the outside of the hip, but it can also show up down the thigh all the way to the outside of the knee. IT Band pain in the hip is often directly correlated to TFL muscle tightness and trigger points. The image below shows where TFL/IT Band referred pain shows up on the body in bright red .
TFL Muscle Pain Patterns 
IT Band pain symptoms are associated with pain on the outside of the thigh. This pain can be aggravated by a variety of habits, particularly when stretching the front of the hip, running, or hiking.
IT Band pain is also associated with TFL muscle tightness. TFL tightness causes hip pain in the form of constant tension in the IT Band. TFL tightness will cause issues stretching the hip flexors, sitting for too long, or stressing the TFL muscle in any way.
Additional TFL & IT Band Pain Symptoms:
- Difficulty leaning back while standing 
- Hip pain after sitting for long periods of time
- Poor hip range of motion 
- Hip pain while running
IT Band Pain In Hip - TFL Muscle Release Visual:
IT Band Release
IT Band pain can often be resolved with muscle release, which we can do via deep tissue massage.
How To Release IT Band:
Short answer: massage the TFL muscle
To release a tight IT Band, we need to loosen the muscle the IT Band is attached to - the TFL muscle. If we can effectively massage and stretch the TFL (the muscle portion of the IT Band - see graphic above), the IT Band will release and be far less tight.
Deep tissue massage of the TFL can be done by the hands of a trained professional, or at home with a purposefully made tool like QL Claw (see above).
What Is The Best Sleeping Position For IT Band Pain?
Generally, on your back. But read our article on the best sleeping position for IT Band pain for a more thorough answer.
IT Band Surgery:
This... is something I know nothing about. Consult a doctor.
IT Band Release Tool:
The best tool I have found for IT Band release is the QL Claw (and using it on the TFL muscle).
 Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.
 Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.