IT Band Syndrome
Pain on the outside of the knee is a common complaint among hikers, runners, cyclists, and other people who have increased their activity level during the summer. When we introduce a new or more intense activity; i.e. repetitive bending over to work in the garden, going on a long hike which includes steep hills, increasing running distances, or riding bikes more frequently; the muscles in our body need time to adjust. If we do not help the muscles adjust by rest and performing specific stretching and strengthening exercises, then imbalances between muscles can occur. These imbalances cause nagging and persistent pain. A common type of injury that occurs is Iliotibial Band Friction Syndrome.
The Iliotibial Band (ITB) is a band of connective tissue that extends down the outside of the leg from the hip to the knee. It extends from a hip muscle, the tensor fascia latae, past the knee joint and attaches to the tibia. Fibers of the ITB are blended with portions of the gluteus maximus, vastus lateralis, and biceps femoris muscle tendons.
ITB Friction Syndrome is the most common overuse injury of the knee. This syndrome is most commonly seen in runners who run multiple days per week. It can also affect cyclists who pedal many miles in a week. It is a repetitive stress injury that results from friction of the ITB as it moves over the lateral femoral condyle at around 30 degrees of knee flexion.
What causes ITB Friction Syndrome?
What are the symptoms?
Interventions for treating ITB Friction Syndrome
Exercises to Strengthen the Hip
1. Clamshells
Lie on either side, then bend knees and hips. While keeping hips and knees bent, slowly lift top-side leg away from bottom leg. Lift leg up attempting to point knee to ceiling. Keep ankles together throughout entire movement. Perform 8 – 12 times with each leg.
2. Single Leg Bridge
While lying on your back with your knees bent, extend one knee. Next, raise your buttocks off the floor/bed. Try and maintain a level pelvis the entire time. Perform 8 – 12 times with each leg
3. Hands and Knees Hip Extensions
While in a crawling position, slowly draw your leg back behind you as you straighten your knee. Perform 8 – 12 times with each leg.
Stretches to Perform Before and After an Activity
1. Calf Stretches
Stand with the middle of your foot on the edge of the stairs while holding onto the railing. Slowly drop heels off until you feel a stretch in the back of your legs keeping your knees straight. Do not bounce. Hold stretch for 30 seconds. Repeat 3-4 times.
2. Hamstring Stretches
While lying down on your back, hook a towel or strap under your foot and draw up your leg until a stretch is felt under your leg and calf area. Keep your knee in a straight position during the stretch. Hold Stretch for 30 seconds. Repeat 3 -4 times on each leg.
3. IT band Stretches
In a standing position, cross one leg in front of the other. Bend forwards towards the floor to feel stretch behind legs. Hold for 30 seconds. Repeat with other leg in front.
In a standing position, cross the affected leg behind your unaffected leg. Next, lean forward and towards the unaffected side while using your arm for balance support. Hold Stretch for 30 seconds. Repeat 3 -4 times.
The Iliotibial Band (ITB) is a band of connective tissue that extends down the outside of the leg from the hip to the knee. It extends from a hip muscle, the tensor fascia latae, past the knee joint and attaches to the tibia. Fibers of the ITB are blended with portions of the gluteus maximus, vastus lateralis, and biceps femoris muscle tendons.
ITB Friction Syndrome is the most common overuse injury of the knee. This syndrome is most commonly seen in runners who run multiple days per week. It can also affect cyclists who pedal many miles in a week. It is a repetitive stress injury that results from friction of the ITB as it moves over the lateral femoral condyle at around 30 degrees of knee flexion.
What causes ITB Friction Syndrome?
- Running on hilly terrain
- Running on road cambers or sloped ground
- Sudden increases in mileage with running and cycling
- Sudden changes in training surface
- Leg length difference
- Muscular imbalances at the hip. thigh, and knee
- Hamstring and Quadriceps muscle tightness and/or weakness
What are the symptoms?
- Diffuse pain on the outside of the knee that is difficult to localize
- Pain will occur when performing the repetitive activity that caused the injury
Interventions for treating ITB Friction Syndrome
- Activity modifications such as taking a break from running, decreasing mileage, change the training surface
- For cyclists, look at proper bike fit, adjust seat height and position
- Ice 3-4 times per day, 10-15 minutes applied to the outside of the knee
- Incorporate strengthening exercises that target the hip abductor and external rotator muscles in your regular strength routine
- Perform a regular stretching routine to include the ITB and surrounding muscles. It is important that surrounding muscles that connect with the IT band are also stretched.
Exercises to Strengthen the Hip
1. Clamshells
Lie on either side, then bend knees and hips. While keeping hips and knees bent, slowly lift top-side leg away from bottom leg. Lift leg up attempting to point knee to ceiling. Keep ankles together throughout entire movement. Perform 8 – 12 times with each leg.
2. Single Leg Bridge
While lying on your back with your knees bent, extend one knee. Next, raise your buttocks off the floor/bed. Try and maintain a level pelvis the entire time. Perform 8 – 12 times with each leg
3. Hands and Knees Hip Extensions
While in a crawling position, slowly draw your leg back behind you as you straighten your knee. Perform 8 – 12 times with each leg.
Stretches to Perform Before and After an Activity
1. Calf Stretches
Stand with the middle of your foot on the edge of the stairs while holding onto the railing. Slowly drop heels off until you feel a stretch in the back of your legs keeping your knees straight. Do not bounce. Hold stretch for 30 seconds. Repeat 3-4 times.
2. Hamstring Stretches
While lying down on your back, hook a towel or strap under your foot and draw up your leg until a stretch is felt under your leg and calf area. Keep your knee in a straight position during the stretch. Hold Stretch for 30 seconds. Repeat 3 -4 times on each leg.
3. IT band Stretches
In a standing position, cross one leg in front of the other. Bend forwards towards the floor to feel stretch behind legs. Hold for 30 seconds. Repeat with other leg in front.
In a standing position, cross the affected leg behind your unaffected leg. Next, lean forward and towards the unaffected side while using your arm for balance support. Hold Stretch for 30 seconds. Repeat 3 -4 times.