You can move your hands across the floor toward the front leg and you will feel more stretch on the outside of your thigh on the other side. The stretch should be on the front of your hip andor thigh. Pdf this article outlines the practical management of iliotibial band friction syndrome itbfs. Jul 20, 2010 when the concept of iliotibial band friction syndrome was first developed, the presumed model was that during activities involving repetitive knee flexion such as running, the iliotibial band repetitively shifted forward and backward over the lateral femoral condyle, causing friction and thus inflammation of the itb. Hold your hands together and move them toward the floor. The first method is to push your leg away from your head as shown. Iliotibial band syndrome exercises what you need to know. Famous physical therapists bob schrupp and brad heineck describe 3 top ways to stretch your it band your iliotibial band. Keep bottom leg straight with the foot in a neutral position. Itb friction syndrome commonly affects people who undertake activities which involve a lot of running triathlon, marathon, athletics etc. Illiotibial band syndrome protocol princeton university.
Iliotibial it band syndrome is a common problem for runners. Deep tissue procedures, such as the graston technique manual therapy that. Each exercise listed after the first three should be. Lean forward as far as you can until you feel a stretch in your buttock. It affects the iliotibial band, which is a long band of tissue sometimes called a tendon or ligament that runs down the outside of the thigh from the pelvis to the tibia shinbone, crossing the hip and knee joints. Pdf iliotibial band syndrome in runners researchgate. Conservative treatment consists of 1 relative rest by decreasing the amount of exercise or training, 2 the use of superficial heat and stretching prior to exercise, and 3 the use of ice after the activity. They can be done as part of your warmup before a run or as a cooldown routine after a run, outside or indoors, or whenever is most convenient.
It is also a common injury that occurs with the athletic population, accounting for 22% of. Iliotibial band syndrome itbs is the result of inflammation and irritation of. Slowly push hips away from the rail until a stretch is felt. Treatment program for runners with it band syndrome maximum. The it band moves as you bend your knee during exercise. Quadriceps and hip flexor stretch hamstring stretch.
Treatment includes activity modification, stretching, and strengthening. It band syndrome, also referred to as itb syndrome, occurs from overuse and repetitive movements, which can lead to pain, irritation, and inflammation in your knee and surrounding tendons. Pdf practical management of iliotibial band friction syndrome in. Etiology, treatment, and prevention of itb syndrome. The exercises strengthen all the muscles supporting the knee and stretch out the iliotibial band, known as the itb, which runs down the outside of the thigh. Most surgeons who have published in the literature ascribe to the iliotibial friction band syndrome theory, and numerous procedures that excise or release this supposedly pathologic portion of the itb have been described. Evaluation of outcomes in assessment of iliotibial band syndrome. Cross the leg farthest from the wall over the other leg, keeping the foot closest to the wall flat on the floor. Treatment includes activity modification, stretching, and strengthening the affected. Iliotibial band friction syndrome itbfs is an inflammatory, nontraumatic, overuse injury of the knee affecting predominantly longdistance runners. There is a gap in evidence based treatment methods for rsi. This fact sheet is designed to provide you with information on iliotibial band friction syndrome.
Iliotibial band syndrome itbs is a common knee injury that usually presents with pain andor tenderness on palpation of the lateral aspect of the knee, superior to the joint line and inferior to the lateral femoral epicondyle. There are many reasons as to why itb syndrome may have been triggered. You may feel a popping or snapping sensation on the outer side of. Apr 10, 2017 subscribe to perfect balance clinic stretching is an important part of any training regime, but there is little evidence that stretching can relieve itbs as the it band is. Use the strap to pull your leg up toward your body, feeling a stretch in your hamstrings. Stretches there are a variety of different stretches a person can try in order to treat iliotibial band syndrome. The pain from iliotibial band syndrome usually goes away in a few weeks with selfcare.
Aug 06, 2010 the iliotibial band or itb is a length of gristlelike tissue that runs down the outside aspect of the thigh as shown in the diagram to the right. Iliotibial band syndrome itbs or it band syndrome is an overuse injury of the connective tissues that are located on the lateral or outer part of thigh and knee. Lying on side with foam roller positioned just above the knee, stack the hips and place the foot of the top leg on the ground. For that reason, itbs is common among runners, cyclists, and people who walk for long distances. All clients are strongly advised to check with their doctor about any specific questions or concerns they may have. It is a hip abducting muscle, so to stretch it you primarily have to adduct the hip. All about iliotibial band syndrome exercises for injuries.
Department of rehabilitation medicine newyorkpresbyterian. But there is not much movement available in that direction. The following itb stretches are designed to improve the flexibility of the itb and tfl muscle figure 1. Stretching the itb is slightly different from stretching other muscles, as the itb is a thick, fibrous band rather than an elastic muscle. Begin by lying on your back with your legs straight and a strap secured on one foot, holding the end in your hands. Position yourself as shown above, with your right leg crossed in front of your left leg. Standing tfl stretch cross the uninvolved leg over the involved leg. Surgical techniques using the itb as an intracap sular or extracapsular lateral knee stabilizer are quite numerous 1,2,7,35,47. The iliotibial band itb is a band of tissue that runs along the outside of your hip, thigh and knee. We include a list of stretches and exercises that can help treat and prevent this condition. You may be instructed to do self massage with a foam roller. Stand facing a wall with your hands on the wall at about eye level. The iliotibial band itb is a thickened fascia that forms from the fascial investments of the tensor fasciae latae. Learn about iliotibial band syndrome and how it is treated.
Active release technique for iliotibial band syndrome background and purpose. Keep your front leg with the knee at 90 degrees and straight out in front with your back leg straight behind you. How to stretch your it band to ease the aches, people often do stretches, where they lean side to. Cross one leg over the other into a figure 4 position. If youve got a nagging pain on the outer part of your knee, especially if youre a runner, it could be a symptom of iliotibial band it band syndrome. Iliotibial band syndrome itbs is a common knee injury that usually presents with. Supine hamstring stretch with strap supine itb stretch with strap. Iliotibial band itb syndrome itbs is the most common cause of lateral knee pain in runners, but may be provoked by other activities such as swimming, rowing, cycling, and hiking. The result will be more obvious when we combine the two into one special test. Slowly lean into the wall until you feel a stretch in the back of your calf. The stretches will assist in alleviating pain and lead to a full recovery.
Excessive lower leg rotation due to overpronation, which will cause friction and inflammation of the itb. Treatment for iliotibial band syndrome itbs usually is conservative. The distal iliotibial band slides over the lateral femoral epicondyle, and during repetitive flexion and extension activities of the knee excessive friction and potential irritation. Iliotibial band syndrome also called it band syndrome, itbs or runners knee is an overuse injury that commonly develops in runners, bicyclists and other athletes. Iliotibial band itb syndrome is widely recognised as an overuse injury that is a common cause of exerciserelated, lateral knee pain in running and other sports. Itbs is one form of presentation of repetitive strain injury rsi. Preference was given to more recent articles and journals with higher impact factors when possible. Itb stretches iliotibial band stretch physioadvisor. Exercises and stretches to treat iliotibial band syndrome. Cross your left leg over your right leg at the ankle. It band syndrome itbs is the result of the large band that runs from your pelvis to your shin getting too. Iliotibial band syndrome itbs iliotibial band friction syndrome itbfs is considered to be one of the most common overuse injuries in the lower extremity, affecting anywhere from 7. People who are diagnosed with iliotibial band syndrome tend to want to rest however, there are specific iliotibial band syndrome exercises that can help ease the discomfort and pain associated. Iliotibial band syndrome it band stretchs, exercises.
Your healthcare provider may recommend stretching and exercises to help you recover. Hereou will find six different iliotibial band stretches to choose from but you only need to do one or two choose the iliotibial band stretches. Cross one leg in front of the other leg and bend down and touch your toes. Many overuse injuries often occur in only the newest of runners. Strengthening exercises for the muscles on the outside of the hip which abduct the leg will help prevent the knee turning inwards when running or walking and therefore help reduce the friction on the itb. You should feel a stretch in the outer part of your left thigh. Iliotibial band syndrome it band syndrome medicinenet. But there are a lot more details that go into the development, care, and prevention of it band syndrome. Iliotibial band friction syndrome itbfs is a frequently encountered overuse injury caused by repetitive friction between the iliotibial band and the lateral femoral epicondyle during active flexion and extension at the knee. Whether you have been diagnosed with or suspect iliotibial band syndrome, your first step should be to rest the affected leg. Often the deceleration of running down hills may lead to the excessive friction. With it band syndrome, many like to debate whether its really the it band thats the cause or if its your tensor fasciae latae tfl. It causes pain and tenderness in those areas, especially just above the knee joint.
Some of the most common causes of itbs are listed below. Iliotibial band syndrome is a common knee injury caused by inflammation of the distal portion of the iliotibial band itb, which results in lateral knee pain. Iliotibial band syndrome, or itb syndrome, is one of these injuries. It can briefly be described as a pain and possible swelling on the outside of the knee. Everything you need to know about it band syndrome including symptoms, prevention, solutions and exercises to relieve the pain. Jan 18, 2018 itb syndrome is a broad and generic term for lateral leg or knee pain related to the itb. Oct 02, 20 itb syndrome pathophysiology plays a key role in guiding surgical treatments. This is an overuse injury, although direct trauma to the outer knee may cause the bursa to get inflamed.
The iliotibial band commonly known as the it band helps to keep your knee stable when you exercise. It is not intended to replace the need for a consultation with your doctor. It is frequently related to hip weakness and instability standing on one leg. The iliotibial band is a thick band of fascia tissue that begins at the iliac crest in the pelvis, runs down the lateral or outside part of the thigh, and crosses the knee to attach into the top part of the tibia or shinbone. Physical medicine and rehabilitation for iliotibial band. Hip thrusts x25 per leg 10 steps r 10 steps l x5 sets 4.
The first three can be started immediately after the injury. Itb syndrome feels like a sharp pain on the outer side of the knee. It is particularly painful with walking when the affected leg strikes the ground. The second method is to hold the opposite leg while maintaining the figure 4 position and pull. Iliotibial band syndrome is an overuse injury usually caused by excessive running. Consider referral to physiotherapy for biomechanical and sport specific rehabilitation. The most common symptom is lateral knee pain caused by inflammation of the distal portion of the iliotibial band. Is iliotibial band syndrome really a friction syndrome. Patients can gradually increase the repetition and frequency of. Lie on your back, reach hands behind your knee, keep knee at 90degree. Iliotibial band syndrome exercises itb friction syndrome. Iliotibial band syndrome strengthening exercises it band pdf. It is made from very tough tissue called retinacular fibres which are largely unable to be stretched.
Often first noticed with running or cycling, it tends to appear sooner into your run or ride as the condition worsens. Iliotibial band syndrome strengthening exercises it band. Background description o it band is a longdensefibrous band of tissue that extends from the hip down to the lateral aspect. The stretch should be felt on the back and lateral side of your hip. If you missed part 4the top 5 causes of itb syndrome click here. However, not only the iliotibial band needs stretching, but also the glutea. Tensor fascia lata tfl musculature merge with the itt. Learn how to combat the pain with itb stretches for improved mobility and painfree movement. The first theory postulates that itb friction syndrome is caused by repetitive itb shifting forward and backward over the lateral femoral epicondyle during knee flexion and extension 2. Sidelying tfl stretch carefully lying on the edge of your bed let your involved leg fall behind the other to obtain a stretch on the side of the hip. Prevention and treatment of it band syndrome breaking muscle.
Steady yourself by holding your left knee with your hands, and from this balanced foundation, inhale and lengthen upward through your spine. Iliotibial band syndrome rehabilitation exercises you may do all of these exercises right away. Hip abductor weakness in distance runners with iliotibial band syndrome article pdf available in clinical journal of sport medicine 103. Evidence based treatment for iliotibial band friction syndrome. Sep 18, 2018 iliotibial band itb syndrome itbs is the most common cause of lateral knee pain among athletes. In some cases, your provider may give you a shot of steroid. Iliotibial band syndrome is the most common cause of lateral knee pain in runners and bicyclists. Lie on your right side and lift your left leg as high as you canno more than 45 degreesin a controlled manner, then lower it back down to the starting position. Read details and see examples of each it band stretches and exercises including wall stretch, assisted stretch, and standing stretch.
Itb syndrome most commonly the pain stays at the knee level, but it can radiate up the outside of the leg and even to the hip. Hold onto a wall or chair on the side you want to stretch. Iliotibial band friction syndrome pubmed central pmc. The increased tone was addressed with active pump techniques, combining soft tissue. On your side, using a towel or band, pull foot back as if stretching quadriceps, and use the opposite foot to push down on distal part of leg. If the stretch is too intense or if you feel pain radiating down your leg, increase the height of the padding under your hips until the stretch is tolerable. This is a painful condition from connective tissue rubbing against the bones at the outside edge of the knee. However, too much of a good thing can lead to overuse injuries. Pubmed 19602011 and sports science 19602011 were searched for sources related to itb syndrome. Turn your back foot slightly inward as if you were pigeontoed. You should discuss the suitability of these exercises with your physiotherapist prior to commencing them. This was first addressed by renne 44 who noticed a painful condition in the. Hereou will find six different iliotibial band stretches to choose from but you only need to do one or two choose the iliotibial band stretches that work best for you. Muscle performance factors and altered loading mechanics have been linked to a variety of lower extremity musculoskeletal disorders.
Lean your hips towards the chair or wall until you feel a stretch on the side of your hip. Dec 28, 2016 release a tight it band by treating glutes, quads, hip flexors and knees. It band syndrome protocol ucsf sports medicine rehab. Iliotibial band syndrome is the most common cause of lateral knee pain in runners and bicyclists the iliotibial band is a thick band of fascia. Make sure your pelvis remains in a neutral position and your butt is forward so you maintain a straight line. Itbs develops as a result of inflammation of the bursa surrounding the itb and usually affects athletes who are involved in sports that require continuous running or repetitive knee flexion and extension. Stand near a wall or a piece of sturdy exercise equipment for support. The tensor fasciae latae, the muscle that most directly controls tension on the iliotibial band, is the most promising target for stretch.
To begin with, the itb stretches should be held for 15 seconds and repeated 4 times at a mild to moderate stretch pain free. Make sure to elevate the knee above heart level until. Stop when you feel a stretch in the hip of your injured leg. Stand with a bent knee on a chair and the standing leg in front. Activity modification and itb stretches can be recommended in primary care. Dont let your hips fall backward so you start engaging your hip. Iliotibial band syndrome is caused by excessive friction of the iliotibial band and the underlying bursa due to repetitive kneebending activities. It is often seen in runners, expecially runners who are either deconditioned, increase mileage too quickly, or have a significant gait deviation in their running mechanics causing biomechanical stresses to the lateral knee. It typically occurs due to excessive training volumes, intensities, durations or frequencies or following a sudden increase in training or change in surface or footwear. All the patients reported in the literature responded to rest and physiotherapeutic treatment for stretching and strengthening the muscles of the itb. Always be sure to ice your knee down after you complete your exercises using either immersion in ice bath, or. Keep your injured leg back with your heel on the floor. I appreciate that i have jammed two exercises into one but when it comes to the rehabilitation of itb syndrome there are really only ever two stretches. A home exercise program that includes a flexibility and strength conditioning routine and modified training recommendations can aid in the treatment and prevention of further injury.
Aug 23, 2017 the warm summer weather is the perfect setting for people to get outdoors and participate in the activities they enjoy. Pdf iliotibial band syndrome itbs is the most common cause of lateral knee pain in runners. The most popular atraumatic clinical presentation concerning the itb is the itb friction syndrome itbfs 18, 32, 3639, 41, 44, 50. In this article, biomechanical risk factors associated with iliotibial band syndrome itbs are described, and a strategy for incorporating these factors into the clinical evaluation of and treatment for that disorder is presented. Iliotibial band itb syndrome is an overuse injury that results from constant friction of the itb over the lateral femoral epicondyle often seen in runners. With your opposite hand, reach across your body, and then gently pull your knee toward your opposite shoulder. Iliotibial band syndrome itbs is one of the most common overuse injuries from running. Department of rehabilitation services physical therapy standard of care. As many as 15 percent of runners are thought to deal with the issue, which causes pain on the outside of the knee. Stretching exercises can be started once acute inflammation is under control. It band stretch stand with the leg you want to stretch crossed behind the other. Strengthening exercises for iliotibial band friction syndrome.