Iliotibial Band Syndrome - Exercises and Treatment

Iliotibial Band (IT Band) Syndrome is a frustratinglift the top foot twelve to twenty-four inches
source of knee and hip pain for athletes, and isdirectly above the bottom foot.
one of the most common causes of lateral kneeHold the position for 5 to 10 seconds and slowly
pain in runners. Most cases of iliotibial bandreturn the leg to the starting position. Focus on
syndrome occur as the result of "too much, toousing the gluteal muscles and not the lateral thigh
soon" or poor biomechanics and can be preventedmuscles to lift the leg. Repeat this exercise 5 to
with these simple tips and listening to your body.10 times in sets of 2 or 3.
Anatomy of the Iliotibial BandHip Hitches (Pelvic Drop) Exercises
The iliotibial band is a thick layer of tissue alongHip hitches or pelvic drop exercises are another
the outer part of the leg that runs from the hipmethod of improving gluteal muscle strength.
to the knee. Irritation can occur either in the hipStand on a step or elevated platform with the
or the outside part of the knee as the iliotibialinjured leg. The unaffected side should hang off
band rubs across the greater trochanter and thethe edge of the step. Slowly relax your hips and
lateral epicondyle of the femur.the pelvis should tilt down towards the unaffected
Iliotibial Band Syndrome Symptomsleg as the foot lowers. Concentrate on contracting
Symptoms of iliotibial band syndrome include painthe gluteal (buttock) muscles on the standing leg
at the outside part of the knee that is worseand bring the hips back to a straight position.
when bending or extending the knee, such asWallbangers
during running or cycling Other symptoms includeWallbangers help provide another method of
pain on the outside part of the hip over theimproving gluteal muscle strength. Stand
greater trochanter.perpendicular and one to two feet away from the
Causes of Iliotibial Band Syndromewall with the injured hip towards the wall. With
Tightness in the iliotibial band is a common cause.arms extended out in front, slowly drop and twist
Weakness in the muscles around the hip andaway from the wall until the hip lightly contacts
buttocks (gluteus muscles) can cause excessivethe wall. Don't hold this position - return to the
hip and leg rotation, resulting in increased stressstarting position. As you perform this exercise,
on the iliotibial band. Other factors that can lead toyou should feel the gluteal muscles in the hip
IT band syndrome include running on a slopedclosest to the wall contract as you return to the
surface such as the beach or road and excessiveupright position.
pronation or rolling in of the foot.Frontal Plane LungesFrontal plane lunges are
Iliotibial Band Syndrome Preventionanother simple exercise that increase gluteal
Iliotibial band syndrome can be prevented bymuscle strength. Standing with the feet
avoiding overtraining, allowing for adequateshoulder-width apart, slowly step to the right and
recovery and rest, following a regular stretchinglower the body into a squat position. Shift the
and strengthening program and selecting properbody weight from the left to the right leg and rise
running shoes for your running style.from the squat position as you bring the left leg
Treatment of Iliotibial Band Syndromeback underneath your body. Repeat the exercise
Ice massage to the painful area for 10 to 15in the opposite direction by stepping to the left
minutes after workouts can decrease the pain.and repeating the above steps.
For acute injuries (less than 2 weeks)Sample Exercise Program
anti-inflammatory medications such as ibuprofenWeek 1
(Motrin or Advil) or naproxen (Aleve or Naprosyn)- Every day - Stretching exercises - Once daily
can help with pain and irritation. In chronic injuriesfor total of 5 to 10 minutes in each session. Ice
there is less inflammation of the tissue, thereforas needed after stretching.
acetaminophen (Tylenol) may be more- Days 1, 3 and 5 - Strength exercises - start
appropriate.with 8 to 10 repetitions and one or two sets.
Iliotibial Band StretchesFocus upon proper form.
Stretching of the iliotibial band is an importantWeek 2
component of proper rehabilitation if the band is- Everyday - Stretching exercises - Twice daily
tight. One simple stretch is to stand and crossfor total of 5 to 10 minutes in each session. Ice
your injured leg behind your uninjured leg andas needed after stretching.
bend over to touch your toes. A more advanced- Days 1, 2,4 and 5 - Strength exercises - start
version of this exercise is to then extend thewith 10 to 12 repetitions and two to three sets.
arms overhead and slowly reach to the oppositeContinue to focus upon proper form.
side (for the right IT band, extend the arms toKey Points to Remember for Iliotibial Band
the left) and then continue the stretch as theSyndrome
arms reach for the floor. As you perform thisThere are several key points to remember with
exercise, you should feel the stretch in the sideiliotibial band syndrome. The focus should be on
and back on the hip. If you experience pain orstretching of the iliotibial band and strengthening
muscle spasm then reduce the motion during thethe muscles around the hip since weakness in
stretch.these muscles often is the primary cause of the
The seated IT band stretch is performed whileinjury. Limiting increases in running mileage to
sitting on the floor with the legs out straight.approximately 10% weekly can help prevent
Bending at the hip and knee, take the injured leginjuries from "too much, too soon". Proper
and cross it over the uninjured leg. Twist thestretching after warming up and before cooling
upper body towards the injured side to continuedown can help prevent re-injury.Sometimes, worn
the stretch. An alternative method is to slowlyrunning shoes with poor arch support can lead to
extend the knee and leg of the tight IT band toexcessive pronation of the foot and increased
increase the stretch.stress on the iliotibal band. Remember that most
Seated Iliotibial Band Stretchrunning shoes last for 300 to 400 miles and need
The"Figure-4' stretch is an exercise that can beto be replaced. Having an expert at a running
done while seated at a desk. While seated, crossshoe store can help in selecting the proper shoe
the ankle of the injured leg on top of the oppositefor your foot and running style.
knee. The stretch can be extended by eitherDon't forget the importance of recovery and
lightly pushing the flexed knee down towards themoderation in an exercise program. While a little
floor or by leaning forward at the waist andsoreness is a sign that your body is adapting to
allowing your body weight to increase the stretch.the increased training, pain is your body's signal to
Hold the stretch for 5 to 10 seconds and thenslow down.
slowly relax.Return to Running and Activity
Foam Roller StretchThe often-asked question of most runners and
A foam roller is a great tool to break up scarendurance athletes is when they can return to
tissue and help with myofascial release of therunning with iliotibial band problems. A gradual
iliotibial band. The stretch is performed by rollingreturn to running can begin once an athlete can
the injured leg back and forth across the foamperform the exercises without pain. While individual
roller. Focus on the hip and outside part of theresults may vary, most iliotibial band syndrome
thigh. The exercise can be done daily for severalcases resolve with 4 to 6 weeks of rehabilitation.
minutes. Try the rolling with the knee straight andA return to running program should focus on
the knee flexed. Gradually increase the amount ofproper biomechanics and avoid triggering factors
time each week.(sloped or uneven surfaces). Studies have shown
Strength Exercises for Iliotibal Band Syndromethat faster paced running has less irritation of the
Strengthening the gluteus muscles is alsoiliotibial band due to the flexed position of the
important in iliotibial band syndrome . Step lungesknee at foot strike versus slow paced jogging.
and leg squats can help increase gluteal muscleWe recommend easy and short fast-paced
strength and are prevent excessive hip internalrunning on alternating days on flat ground for the
rotation and added stress across the knee andfirst week with a gradual return to longer, slower
iliotibial band. For athletes that are trying to rehabpaced runs over the next 2 weeks. Additionally,
from IT band syndrome, a gradual approach toavoiding downhill running or on sloped surfaces
strength training of the gluteal muscles is(side of the road) can help prevent re-injury.
recommended.The rehab stretches and exercises should
Side Leg Liftscontinue during the return to running phase of the
Side leg lifts focus on strengthening the lateraltraining program.
gluteal muscles as well as teaching the athlete theDownload a pdf version with pictures of the
correct muscles to focus on. Side leg lifts arestretches from the Coastal Sports and Wellness
performed lying on the side, with the injured legwebsite.
on top. Keeping the hip and knee straight, slowly