Can Rowing Cause IT Band Pain? What HYROX Athletes Should Know
- Dr. Kelsey Changsing, PT, DPT
- 4 days ago
- 5 min read
Iliotibial (IT) band pain, also known as IT Band Syndrome (ITBS), is an overuse injury that commonly causes pain along the outside of the knee during repetitive activities such as rowing and running. Rowing can contribute to symptoms when training volume exceeds the tissues' ability to recover.
Managing IT band pain can include temporarily adjusting rowing volume, improving rowing technique, and addressing relevant strength and mobility needs. Remote physical therapy for HYROX athletes can help identify contributing factors and develop an individualized plan that supports recovery while maintaining training when
appropriate.
Understanding IT Band Pain
The IT band is a thick band of fascia (connective tissue) that runs from the outside of your hip, down the outside of your thigh, and attaches near the outside of your knee and upper shin. The IT band, along with the gluteus maximus (glute max) and tensor fascia lata (TFL) muscles, help to stabilize your knee.
IT band pain, or IT Band Syndrome (ITBS), is a common overuse injury that causes pain with repetitive knee bending and straightening, such as with rowing and running. Pain is usually felt near the outside of the knee, although some people may experience pain higher up near the outside of the hip.
If you have IT band pain, you may also have some tenderness on the bony bump near the outside of your knee and a feeling of “tightness” along the outer thigh. The pain usually starts after a certain distance or amount of time on the rower and gradually gets worse. It usually improves with rest but will return once you start rowing again
ITBS was previously thought to be from friction of the IT band rubbing on the outer knee with repetitive knee motion. But updated research suggests that painful compression of the IT band on tissues underneath is more likely, considering the IT band is actually firmly attached to the outer knee.
How Rowing Can Cause IT Band Pain
Rowing can increase your risk of developing IT band pain as an activity that requires repetitive knee bending and straightening. However, just because you use a rowing machine doesn’t mean you will develop ITBS.
The underlying cause of ITBS is overuse, which usually occurs when doing too much, too soon, or with inadequate rest between training sessions. The tissues getting compressed by the IT band aren’t allowed enough time to recover, leading to constant irritation while rowing and worsening pain.
Factors that can contribute to this include suddenly incorporating a lot more rowing into your workouts, poor sleep, and inadequate rest days between training sessions.
As a HYROX athlete, it’s also important to consider the impact of running on developing IT band pain, since it’s one of the most common activities associated with IT band pain. If you are dealing with ITBS, be especially mindful of workouts with a lot of rowing in addition to running when tracking your training volume.
And while muscle weakness in the hips has not been found to cause IT band pain, improving hip strength and hip drive on the rower can both decrease it band pain and improve rowing performance.
How to Manage IT Band Pain Caused by Rowing
Addressing your training volume is the first step towards managing overuse injuries like IT band pain. This doesn’t mean avoiding rowing completely, but you might have to temporarily decrease the amount of rowing you’re doing during training while symptoms calm down.
One way to do this is to figure out how far you’re able to row before experiencing symptoms and use that as your baseline.
For example, if you start having symptoms after rowing for 250 meters, stick to rowing 200 meters during workouts for a couple weeks. Then, try 250 meters again. If that’s now pain-free, stick to 250 meters for another couple of weeks before similarly increasing again.
Rowing Technique
Having a proper rower setup and improving your technique can help decrease excess strain on your tissues, including around the IT band, as well as improve your rowing performance.
Start by adjusting the footrest so the straps sit across the ball of your foot and your shins are vertical during the catch.
For the damper, choose a setting that allows you to generate power and feel strong during the pull without feeling like a max effort every stroke. Don’t just leave it at 10.
And when rowing, you want to think push → lean → pull during the drive, then reverse the sequence during the recovery portion of the stroke. Push with your legs like you’re doing a deadlift, then lean back by hinging through your hips before pulling with your arms to your chest. The reverse during the recovery portion.
This sequence allows you to take advantage of your stronger hip and leg muscles to generate power instead of relying too heavily on your knees, arms, or lower back.
Strength and Mobility Exercises
As mentioned earlier, hip weakness hasn’t been found to contribute to IT band pain but can be a consequence of it instead. Addressing any muscle weaknesses is a good idea in general, but it can also decrease pain by improving tissue quality. Same thing with hip flexibility.
For rowing specifically, strengthening the glute max and hip abductors helps with your ability to generate power during the drive portion of the stroke. Improving hip flexion, internal rotation, and external rotation mobility can also help with being more comfortable on the rower.
Since ITBS involves compression, directly foam rolling the outer knee or trying to stretch the IT band can compress the tissues beneath even more, making pain worse. But general stretching and foam rolling other areas can temporarily help with pain if needed.
When to Seek Professional Help
If you’ve been dealing with IT band pain for several weeks, you find yourself heavily modifying your training because of pain, or if pain is starting to affect your daily activities, an evaluation from a physical therapist can help determine whether your pain is actually due to your IT band.
A physical therapist familiar with HYROX athletes can evaluate your movement and current training schedule and create a personalized plan to address your pain without requiring you to stop training altogether.
HYROX Athlete Physical Therapy in Nevada
If you need help with IT band pain and are located in Nevada, I can help. I specialize in remote physical therapy for HYROX athletes to help you recover without stopping training or rehab taking over your life.
Schedule a Virtual Movement Assessment below to get back to rowing pain-free.
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References:
Hutchinson LA, Lichtwark GA, Willy RW, Kelly LA. The Iliotibial Band: A Complex Structure with Versatile Functions. Sports Med. 2022 May;52(5):995-1008. doi: 10.1007/s40279-021-01634-3. Epub 2022 Jan 24. PMID: 35072941; PMCID: PMC9023415.
