Iliotibial Band Syndrome: General Thoughts

The top 10 treatments of IT Band Syndrome are:

1. Develop an appropriate stretch that you can do to reduce the pain, then do that stretch 5 times daily. Go to Youtube and type drblakeshealingsole iliotibial band stretches.

This is a yoga version of Iliotibial band stretching to stretch the lateral side of the hip and knee. It can be done also standing upright and also leaning against a wall.

This version of iliotibial band stretching can be done laying all the way done and then draping your leg over the other with a gentle pull from your opposite hand.

2. Gradually strengthen the hip abductors with limited range of motion. I prefer theraband progressive resistive exercises. Keep your knee straight as you do them.  

Whether you are doing these standing or side lying, and especially if you add resistance, please you limited motion (max 3 inches away from other heel, starting 1-2 inches in front of and across the other foot). Too far away from mid line irritates the hip and is not in the functional range we need.

Here with the resistance bands you walk slowly sideways in one direction, then the other, building up time. I would use a longer theraband so you did not have to have your knees so bent.

3. Ice pack for 10-15 minutes or ice massage 5 minutes 3 times daily.

4. Use activity modification, typically you can run until you get initial symptoms, stop stretch walk several minutes, and begin running again. Repeat as needed with 20 minute ice pack afterwards.

5. Physical therapy to stretch, decrease inflammation, strengthen, and look for biomechanical faults.

6. Correct any biomechanical faults that may be causing like over pronation, over supination, or short leg syndrome.

7. If symptoms are mainly at the tibial attachment at Gerdy’s Tubercle, get a baseline x ray.

8. If symptoms do not respond at the hip greater trochanter, consider a cortisone injection for trochanteric bursitis.

9. Massage, either professionally or self, should be limited to the area above the knee and below the hip to avoid the bony prominences. This includes when you stretch/massage with the ethafoam roller.

10. Taping of the leg has begun to prove helpful at times.

Not this type of taping!!

More like this type (there are many versions)

11. Like any tendinitis, BRISS is initiated. But, if symptoms linger, you have to think deeper, and consider xrays, nerve testing, MRIs, etc.

Knee Pain With Runner: Possible Ilio-Tibial Band Syndrome

Hi Dr. Blake,

I am a runner (no more than 10k races) and have had a pain on the side of knee for the past month or so.  I was told that it could be my IT band and to do stretches to help recover from the pain.  I run in the City so I thought the pain might also be from running downhill. 

Dr Blake's Note: The Ilio Tibial Band runs down the lateral or outside aspect of the leg from the pelvis to the tibia. It most commonly causes symptoms on the outside of the hip or the outside of the knee. 

Can you recommend the most efficient stretches and any other suggestions for a quick recovery? 

Dr Blake's Note: IT Band Syndrome is almost a pure runners problem. Rarely ever see it in other sports. Here are some common IT Band stretches.

 Should I be icing my knee after every run?

Dr Blake's Note: IT Band Syndrome is a form of tendinitis. All the common treatments of Tendinitis should be employed to help. Please see the link on BRISS for tendinitis treatment. 

http://www.drblakeshealingsole.com/2010/06/briss-principle-of-tendinitis-treatment.html

  Is it possible that it could be something else?

Dr Blake's Note: Definitely, it is uncommon for women to get IT Band tendinitis around the knee, but not rare. If there is any swelling, it is not IT Band Syndrome. If it does not feel better with stretching during a run (I love the lateral wall lean stretch while running), it is not IT Band Syndrome. It could be lateral knee joint pain, lateral collateral ligament, lateral hamstring, etc to name a few. If the pain is on both knees in roughly the same spot, it is most definitely IT Band. 

  Would a knee brace be unnecessary if it really is my IT band?

Dr Blake's Note: If it is IT Band, knee braces should not help, and may hurt. If you experiment with a simple knee brace while running, and you feel somewhat better, continue to wear. 

It take me a few days to recover from the pain after a run.  I have my longest race coming up in September and don't know if it's safe to run because the pain is still bothersome.

Thank you,

Lesley

Lesley, Thanks for the email. Definitely do not run through pain that starts in the middle of a run.You will definitely make it worse.  Stop, try to stretch out the IT Band, and then continue to run only if the pain subsides. If you can get PT for it with the upcoming race, go for it. They can normally calm it down quite well. For a race in September, it is too late to change you biomechanics too much, but is would be okay to make a shoe change if your shoes are too worn down (usually over 500 miles). Hope this helps. 

Iliotibial Band Tendinitis: 3 Common Stretches

The above video demonstrates the 3 common iliotibial band stretches I show patients suffering from this common running injury. It is almost rare in other sports, since it is a repetitive stress syndrome where the ilio tibial band rubs over either the greater trochanter of the femur at the hip or the lateral femoral epicondyle on the outside of the knee. Women are more prone for hip IT Band pain, and men more prone for knee IT Band pain. The stretches should be done 2 sets of 30 second count/5 deep breathes, and 5 to 10 times per day. Many runners can feel it coming on (called prodrome symptoms) and can stretch it out before the pain gets too intense. I had one patient who would feel it around 2 miles into a run, and was able to finish the Tahiti Marathon by stopping every 2 miles to stretch out the band. Most of the time however, subsequent stretches gives less time running (diminishing returns). The ethafoam roller can be used each morning and evening to elongate the fibers. Never use the roller over the boney prominences at the hip or knee. If stretching ever increases the pain, stop immediately and consult with your health care provider. You may have bursitis, nerve pain, hip joint pain, or a stress fracture. For normal ilio tibial band tendinitis, the stretching is a very relaxing exercise and the symptoms feel better (at least temporarily).