WHAT IS ILIOTIBIAL (IT) BAND SYNDROME?

Iliotibial band syndrome is often called IT band syndrome (ITBS). It is a health problem that causes pain on the outside of the knee. It most commonly happens in athletes, especially distance runners, or those new to exercise.

The bones of your knee joint are your thighbone (femur), your shinbone (tibia), and your kneecap (patella). Your iliotibial band is a strong, thick band of tissue that runs down the outside of your thigh. It extends all the way from your hip bones to the top of your shinbone.

When you bend and extend your leg, this band moves over the outer lower edge of your thighbone. With repeated bending and extending of the knee, this movement of the iliotibial band may irritate surrounding tissues, causing pain.

Although anyone can develop it, iliotibial band syndrome is relatively common in distance runners.

CAUSES

Common causes for ITBS are muscle weakness of the hip abductors and  improper function or weakness in the gluteal muscles. Muscle weakness of the hip abductors (the muscles that move your hip and leg outward) causes increased hip internal rotation and knee adduction (knee moving inward), this causes the IT Band to compensate for the weaker hip abductors in order to stabilize the leg. If the lateral gluteal muscles are found to be weak or functioning improperly, this will result in other muscles - including the IT band - to have to compensate, which will cause contraction of the IT band.

TREATMENT

STEP 1: REDUCE INFLAMMATION

 

Ice the affected area. 

Topical Anti-Inflammatory

Anti-Inflammatory (NSAID)

STEP 2: STRETCH

Exercises to stretch the IT band and related structures.The best exercises to start the physical treatment of ITBS are passive or static stretching exercises. This will lengthen the IT band and will reduce friction with the outer lower edge of the thighbone. However, not only the IT band needs stretching, but also the glutea.  Furthermore, if the glutea is too short, it will also provoke a rotation of the leg and this will again create an abnormal stress on the IT band, resulting in ITBS. Stretching exercises need to be performed at least 3 times a day.

STANDING IT BAND STRETCH

The standing ITB stretch is a good one because it can be done anywhere — at home or the office, or at the gym before working out. You can lean on a wall for balance if it is easier. Here is how you do it:

  1. Stand upright.

  2. Cross the involved (hurting) leg BEHIND the opposite leg.

  3. Lean to the uninvolved side (away from the sore side) until you feel a stretch across the affected iliotibial band.

  4. Hold for 30 seconds.

  5. Uncross your legs and stand up straight again.

  6. Repeat four more times.

 

Some people feel a stretch in the area of their hip where the ITB arises, while others feel a tightness at their knee during this stretch.

Click here to see a video demonstration of this stretch.

LYING CROSS-OVER  HIP STRETCH

The Lying cross-over hip stretch is a good one because it can be done anywhere — at home or the office, or at the gym before working out. Here is how you do it:

  1. Lay on your back.

  2. Bring your knee up toward your chest.

  3. With the opposite hand, grab just above the knee and pull your leg across your body.

  4. Ensure that shoulders remain in contact with the ground.

  5. Hold for 30 seconds.

  6. Slowly return to the original position

  7. Repeat on the opposite side.

 

Some people feel a stretch in the area of their hip where the ITB arises, while others feel a tightness at their knee during this stretch.

PIGEON POSE STRETCH

The Lying cross-over hip stretch is a good one because it can be done anywhere — at home or the office, or at the gym before working out. Here is how you do it:

 

  1. Start in Downward Dog.

  2. Lift your right leg up and sweep it through to your mat, folding it and placing it on the mat.

  3. Keep your right foot flexed to protect the knee.

  4. Keep your hips square and level, with the left hipbone pressing toward your right foot.

  5. Inhale and press your hands into the mat, getting as much length in the spine as possible. Your left leg is straight behind you with the toes pointed.

  6. Exhale as you walk your hands forward on the mat, coming out to your edge.This might be on the elbows, with the arms extended all the way out or right where you started.

  7. Hold this pose for one minute. Remember to breathe!

  8. Switch sides.

 

You should feel this stretch throughout the glute and hip muscles and even into the lower back.

TFL RELEASE

STEP 3: STRENGTHEN

The next important phase in the physical treatment of ITBS is to perform exercises to strengthen the muscles in the affected area. Since ITBS is often associated with hip abductor weakness, strengthening and stabilizing of the hips and glutes will be beneficial in the treatment of ITBS. The following are some of our favorite exercises for strengthening the hip and glute muscles in order to prevent ITBS.

SIDE LEG LIFT

BACK BRIDGE

HIP AND GLUTE STABILITY

*Always consult with your medical professional. We do not claim to be medical professionals, these are observations of things that we have seen to work in our own experience. These are here for your own personal knowledge and study not for any medical diagnosis. 

REFERENCE:

Iliotibial Band syndrome (n.d.). In Physiopedia. Retrieved January 31, 2020 from https://www.physio-pedia.com/Iliotibial_Band_Syndrome 

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