Troubleshooting Iliotibial Band Syndrome - 5 Strategies to Fix It

Iliotibial Band Syndrome is a common condition experienced by many, but is particularly common in runners and cyclists. Iliotibial Band Syndrome (ITBS) is characterized by pain on the outside of the knee, where the iliotibial band inserts into the lower leg. This blog post will discuss what causes iliotibial band syndrome and five ways that you can fix it at home. 

Iliotibial Band Syndrome is an overuse injury caused by repetitive flexion and extension of the knee. This overuse syndrome causes compression of the tissues under the ITB, which can lead to painful symptoms. Therefore, the first step to treating ITBS is to modify your activity level. It is generally recommended that you do not increase your intensity, frequency, or duration by more than 10% per week. So if you are experiencing pain, you'll need to decrease your activity level. 

Another important consideration when treating ITBS is how you run. Uncontrolled pronation, slower running cadence, and lower leg internal rotation have all been suggested to contribute to ITBS. Having your gait evaluated by an expert will allow you to focus on some of these biomechanical issues you may never have noticed. 

To troubleshoot ITBS, you’ll need three things: a foam roller, a big (lacrosse ball or baseball work great), and a mini-loop band. 

  1. Quad Foam Rolling - Start with the foam roller placed just above your knee cap. The outer quad is commonly more tight, but the whole quad should also be addressed. Rotate your foot inward to focus on the outer quad first. Slowly roll up the quad to the front of the hip and then back down. Repeat with your foot in neutral (to address the middle of the quad) and also turned outwards (to address the inside of the quad). 
  2. Gluteal Foam Rolling - Start by sitting on the foam roller. Rotate to one side and cross the same leg you are rotating towards over the other (ie. if you are rotating towards your right gluteal, cross your right leg over your left). Roll up towards your belt line then down to the bottom of the gluteals. You can also rotate your body to focus on the inside or outside of the gluteals as well. 
  3. Knee Flexion with Ball - Place the ball just in front of your iliotibial band above your knee. Slowly flex your knee and then fully extend. Repeat this motion as you move the ball along your quads. 
  4. Single Leg Bridge - Start by lying face up with your knees bent. Grab one of your legs behind the knee and pull towards your chest. Squeeze your glutes and lift your hips towards the ceiling. You should be able to draw a straight line between your knee, hip, and shoulder (this makes sure you are getting full extension in your hips). Once at the top position, take a couple breaths in then slowly lower your hips.
  5. Standing Hip Abduction - Place the mini-loop around your ankles. Keeping your torso upright, push one of your legs towards the side. While you are doing this you want to keep your toes straight forward so that you are recruiting your gluteals and not your hip flexors. Hold this position for 5 seconds, then repeat on the other side. 

In conclusion, there are many treatment options for treating iliotibial band syndrome. These five exercises provide a solid foundation for helping you if you are dealing with iliotibial band syndrome. Sometimes joint mobilizations or soft tissue therapies are needed to help resolve ITBS. If your syndrome is not improving on its own, it is always recommended to have it evaluated by a qualified professional.

References:

Lavine, Ronald. "Iliotibial Band Friction Syndrome." Current Reviews in Musculoskeletal Medicine Curr Rev Musculoskelet Med 3.1-4 (2010): 18-22.

Noehren, Brian, Irene Davis, and Joseph Hamill. "ASB Clinical Biomechanics Award Winner 2006." Clinical Biomechanics 22.9 (2007): 951-56.