If you struggle with IT band pain and are having trouble getting a good night’s sleep, the issue may be related to your sleeping position. The reality is that there is no one best sleeping position for IT band pain, there is only the best sleeping position to relieve the pain in your IT band.
To find this position, you have to consider a few factors:
- Your current mattress: Are the components properly supporting your body?
- Your preferred sleeping position: Are you putting unnecessary pressure on your hips and knees?
At Texas Mattress Makers, we understand that proper rest is crucial for injury recovery, and we’re here to help you find the perfect sleep solution to iliotibial band pain. With over 45 years of experience crafting quality mattresses right here in Downtown Houston, we’ve helped countless customers find comfort and relief through better sleep positioning and the right mattress setup.
What is IT band syndrome?

The iliotibial band (commonly referred to as the IT band) is a thick band of tissue that runs along the outside of your thigh, running from your hip to your knee. When this tendon becomes tight or inflamed, typically due to repeated rubbing against your hip or knee bones, it creates a condition known as IT band syndrome that causes consistent pain in the area.
What are the symptoms of a tight IT band?
Common symptoms of iliotibial band pain and tightness include:
- Sharp, burning pain along the outside of the thigh and knee
- Aching or stiffness in the hip area
- Pain that worsens with activity, especially running or walking up stairs
- Tenderness when pressure is applied to the outside of the knee
- Pain that radiates from the hip down to the knee
- Discomfort that gets worse when lying on your side
These symptoms can significantly impact your sleep quality, creating a cycle where poor rest slows down your recovery process.
Is IT band syndrome worse at night?
Many people find that IT band syndrome feels worse at night because lying down on a mattress can put excess pressure on the IT band, making it seem impossible to get a good night’s sleep. For many people, figuring out how to sleep when your IT band hurts or is tight can be quite a challenge, but it is essential for your recovery in the long term.
How quality sleep supports injury recovery
Injury recovery and quality sleep go hand-in-hand. During deep sleep, your body releases growth hormones, which are essential for tissue repair and regeneration. Quality sleep helps reduce inflammation throughout the body, including in your IT band.
When you don’t get enough quality rest, your body produces more cortisol, a stress hormone that can actually increase inflammation and delay the healing process. This is why finding the best sleeping position and creating an optimal sleep environment is helpful for anyone dealing with IT band pain.
Here are some tips from our Texas Mattress Makers experts on how to find the best sleeping position for IT band pain and ways to improve your sleep experience to wake up pain-free.
Tip #1: Find the best sleeping position for your body
Which sleeping position is best for reducing pain in your IT band? While many sources might cite one posture as “the best sleeping position for IT band pain,” the real answer is a lot more nuanced. What might relieve pain for you may not work for someone else struggling with tendon pain — your body and your needs are completely unique.
Additionally, we all have our preferences when it comes to how we want to sleep. Teaching yourself to sleep in a new position is possible, but as long as you are positioned in a healthy way, you can still rest in the way that suits you.
Position | Pillow Placement | Hip Support | Leg Positioning |
Side (opposite of your hurt IT band) | Place a pillow between your knees to keep your hips aligned and reduce strain on your IT band. | The ideal mattress for hip pain will cradle your body’s natural curves to relieve pressure points while keeping your spine properly aligned and preventing that sinking feeling. | Keep your legs slightly bent at the knees, but avoid pulling them too tightly toward your chest, as this can create additional tension in your hip flexors and IT band. |
Back | Place a pillow under your knees to maintain the natural curve of your lower back and reduce tension in your hip flexors, which can contribute to IT band tightness. | Keep your legs slightly apart and avoid rotating your affected leg inward. You might find it helpful to place small pillows on either side of your legs to prevent them from rolling inward during sleep. | If you have an adjustable mattress base, slightly elevating your legs can help reduce swelling and improve circulation, which supports the healing process. |
Stomach | Use a thinner pillow for your head to prevent neck strain that can create compensatory tension throughout your body. | Place a thin pillow under your hips to reduce the arch in your lower back and minimize strain on your IT band. | Try sleeping with your affected leg slightly bent and pulled up toward your side, similar to a modified recovery position to reduce tension. |
Most sources will recommend that sleeping on your back with your knees elevated with an adjustable base is the safest way to prevent excessive strain and iliotibial band pain. However, like we mentioned, with the right mattress and accessories, you should be able to sleep in your desired sleep position comfortably and wake up without pain.
What not to do when you have IT band syndrome
Certain sleeping positions and habits can worsen IT band pain and should be avoided:
- Sleeping directly on your affected side without proper cushioning and support
- Crossing your legs while lying down
- Sleeping in positions that cause your knees to touch or overlap (a pillow can help reduce the pressure)
- Using a mattress that’s too soft, which can cause your hips to sink and create misalignment
- Neglecting to support your knees and hips with appropriate pillows
Tip #2: Invest in an adjustable mattress base
An adjustable mattress base can be a game-changer for people dealing with IT band pain. These innovative sleep accessories allow you to customize your sleeping position throughout the night, providing targeted relief exactly where you need it.
With an adjustable base, you can:
- Elevate your legs to reduce swelling and improve circulation
- Find the perfect angle for your upper body to reduce pressure on your hips
- Make adjustments throughout the night without disturbing your partner
- Create a zero-gravity position that evenly distributes your body weight
- Easily transition between different positions as your pain levels change
- Slip in and out of bed easier by adjusting the bed’s height
At Texas Mattress Makers, we’ve seen firsthand how the benefits of an adjustable mattress base can transform sleep quality for people with various types of pain and mobility issues. Because IT band syndrome in seniors can make it even more difficult to get in and out of bed comfortably, we highly recommend adjustable bases for elderly sleepers.

Enjoy Pain-Free Sleep
Tip #3: Prioritize your mattress’s materials
When customers ask us for our recommendations for the best mattress for back pain, shoulder pain, hip pain, and more, we always give similar advice: find a mattress with top-quality comfort and supportive components that will suit your body and needs.
Even if two sleepers struggle with the same type of pain, such as IT band pain, their bodies will interact with their mattresses differently. Your height and weight, preferred sleeping position, and other considerations contribute to which type of mattress will help you get the best night’s sleep. For example, a mattress that’s too soft can cause your hips to sink, creating misalignment that puts additional stress on your IT band, while a mattress that’s too firm can create pressure points that worsen pain. It’s all about balance.
If you visit a Texas Mattress Makers showroom, we can help you find a mattress that features components designed to support your body throughout the night, while providing sufficient cushion for pain relief.
Searching for Pain-Free Sleep Solutions? Texas Mattress Makers Has You Covered.
Finding the best sleeping position for IT band pain often requires some experimentation and patience. Remember, the goal is to reduce pressure on your IT band while maintaining proper spinal alignment throughout the night.
At Texas Mattress Makers, we’re committed to helping our Houston community achieve better sleep and improved quality of life. Whether you’re dealing with IT band pain, hip discomfort, or back pain, our locally-crafted mattresses and adjustable bases can provide the support and comfort you need for optimal recovery.
Visit any of our mattress stores in Houston to experience the difference that proper sleep support can make in your recovery journey. Our team of mattress experts can help you find the perfect mattress and sleep positioning solutions for your specific needs. Because when it comes to healing and recovery, quality sleep isn’t just important — it’s essential to being the happiest and healthiest version of yourself.
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