Experiencing pain in your iliotibial (IT) band can negatively impact your ability to get a good night’s rest. The IT band is a fibrous tissue (tendon) that runs along the outside of your thigh - and just like most parts, it is also at risk for tension and inflammation.
If you feel this is you, let’s find the best sleeping position for IT band pain, review the causes of iliotibial band syndrome, and of course, explore ways to manage your pain.
The Best Sleeping Position for IT Band Pain
Let’s get straight to the point. Because of the location of your IT band, the best sleeping position is on your back. Additionally, placing a pillow under the affected knee can help with discomfort. This position is ideal because it can reduce direct pressure on your IT band while promoting the natural alignment of your legs and hips.
You can also sleep on your unaffected side (with a pillow between your knees) as long as you aim to maintain proper spinal alignment. Hopefully, you’re not unfortunate enough to experience bilateral IT band pain, in which case, sleeping on your back is still your best bet.
You’ll want to reevaluate your nighttime routine before hopping into bed for 6-8 hours - little to no movement for long periods of time can increase the likelihood of feeling stiff. Lying in bed can cause muscle tightness so while positioning does matter, there are other contributing factors as well.
You can always add a relaxing CBD massage to your routine which can also promote relaxation and pain relief for sore muscles. If you can tolerate it, a light stretching routine can help too!
Finally, you’ll want to use a mattress that provides the right level of support and contours to your unique body. Look for a medium-firm to firm mattress to maintain proper spinal alignment. Other options also include memory foam or hybrid mattresses.
The Prequel to The Best Sleeping Position for IT Band Pain
If you’re not sure about how you got into this position (no pun intended), IT band pain has several possible causes. Iliotibial band syndrome (ITBS) itself is when the IT band gets irritated or swollen from rubbing against your hip or knee bones. [2]
With Iliotibial band syndrome being a possible cause for lateral knee pain (2nd leading cause of pain in runners), authors Hadeed and Tapscott state in their findings, “It was first seen in US Marine Corps recruits during their training in 1975 and has been diagnosed frequently in long-distance runners, cyclists, skiers, and participants of hockey, basketball, and soccer since then. These activities all depend on rapid and prolonged cycling of the knee through flexion and extension.” [1]
Military trainees, particularly the U.S. Marines, have an unusually high percentage of people who get ITBS (a whopping 20%). Another example of frequent flyers with ITBS is found in runners at 12%. [2]
There you have it… if you’re an avid athlete, odds are your IT band is the culprit to your outer thigh tightness and/or knee discomfort. If you feel this applies to you, take care of any IT band tightness with diligence. We have a video on how to use the QL Claw to perform deep massage in this specific area!
Other Contributing Factors for IT Band Pain
Modifiable:
- Running on a tilted surface
- Hill running
- Improper training techniques
- Sudden changes in training intensity [1]
- Warming up too fast pre-workout
- Cooling down too fast post-workout [2]
Anatomical
- Internal tibial torsion
- Hip abductor weakness
- Excessive foot pronation
- Arthritis [1]
Symptoms of ITBS
- Hip pain
- Clicking sensations
- Knee pain
- Redness and warmth [2] - Most people report their first episodes of pain feel like burning and aching. As the condition progresses, pain may become more sharp and severe.
As you may notice, IT band pain has a recognizable set of symptoms along with a root cause often involving physical activity. It’s been noted that this condition is not typically found in the non-active population - and although the pain shows up after activity, as it worsens you may experience discomfort even at rest.
If necessary, your healthcare provider may use radiographic imaging to rule out other conditions such as osteoarthritis or fractures. Other tests they may run include an MRI or ultrasound which may display abnormalities such as distal IT band thickening. [1]
IT Band Pain Management
The first thing to do (just like in other times you’re in pain) is to REST! This may sound like a broken record to you at this point but this doesn’t make it any less true. Ice and heat may help during the initial days the pain hits, and once pain-free (during both activity and when touched) you can experiment with a gradual return to your routine.
If you’re referred to physical therapy, you’ll find yourself doing stretches that involve IT band abduction which is meant to strengthen and lengthen while simultaneously getting rid of tension. If you have a foam roller at home, you can try and get some myofascial release done right now!
Just doing the first few steps of rest, stretching (as tolerated) with a foam roller, and also using the QL Claw as noted in the video above, I’d say you’re on the right path to being free from IT band pain! With the correct combination of interventions and some persistence, approximately 50-90% of those with ITBS report improvement in 2-6 weeks.
Despite all this information at your fingertips, remember that this is not meant to replace medical advice provided by your doctor - make sure you see a professional if your pain does not subside!
The Best Sleeping Position for IT Band Pain: Conclusion
Hopefully, the information provided here has shed some light on IT band pain, particularly how to sleep with it, but also how to manage it while awake! Never underestimate the benefits of taking enough time to recover and a good night’s sleep.
In hopes that you’ll never have to use invasive interventions such as steroid injections or surgery, doing what you can now (even proactively) can help you stay ahead of the game.
Now that you've read about the best sleeping position for IT band pain, check out our page on sleeping position for sacroiliac joint pain relief and how to stretch Psoas while sleeping!
Sources:
[1] Hadeed, A., Tapscott, D. Iliotibial band friction syndrome. StatPearls, 2023.
[2] Iliotibial band syndrome. my.clevelandclinic.org, 2021.
[3] Charles, D., Rodgers, C. A literature review and clinical commentary on the development of iliotibial band syndrome in runners. International Journal of Sports Physical Therapy, 2020.