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.

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).