Iliotibial (IT) Band Syndrome

What is iliotibial band syndrome?

lliotibial band syndrome is inflammation and pain on the outer side of the knee. The iliotibial band is a layer of connective tissue. It begins at a muscle near the outer side of your hip, travels down the outer side of your thigh, crosses the outer side of the knee, and attaches to the outer side of your upper shin bone (tibia).

How does it occur?

lliotibial band syndrome occurs when this band repeatedly rubs over the bump of the thigh bone (femur) near the knee, causing the band to be irritated. This most often occurs in running.

This condition can result from:

• having a tight iliotibial band
• having tight muscles in your hip, pelvis, or leg
• your legs not being the same length
• running on sloped surfaces
• running in shoes with a lot of wear on the outside of the heel

Symptoms

The symptom is pain on the outer side of the knee. How is it diagnosed? Your health care provider will examine your knee and find tenderness where the band passes over the bump on the outer side of your knee. Your iliotibial band may be tight. How is it treated?

Treatment

Initial treatment for Iliotibial Band Syndrome includes the following acronym, LUSKIN:

Iliotibial Band Stretch (Side Leaning)
Stand sideways to a wall with your injured leg toward the outside. Place the hand nearest the wall on the wall for support. Cross your uninjured leg over the injured leg, keeping the foot of the injured leg stable. Lean into the wall. Hold the stretch for 30 seconds and repeat 3 times.

Hamstring Stretch
Lie on your back and bring the affected leg toward your chest. Grab the back of your thigh and try to extend your leg. Hold this position for 30–60 seconds, feeling a stretch in the back of your thigh. Repeat 3 times. You may also try this with a towel around your foot if it is more comfortable.

Quadriceps Stretch
Stand sideways to a wall, about an arm’s length away, with your injured leg toward the outside. Keep the hand nearest the wall against the wall for support. With your other hand, grasp the ankle of your injured leg and pull your heel up toward your buttocks. Do not arch or twist your back. Hold this position for 30 seconds. Repeat 3 times. This stretch may also be done lying on your opposite side while grasping the ankle of the affected leg. Do not arch or twist your back. Hold 30 seconds and repeat 3 times.
This may also be done while laying on the opposite side and grasping
the ankle of the affected leg. Do not arch or twist your back. Hold this
position for 30 seconds. Repeat three times.

Gluteal Stretch
Sit with your left leg straight out in front of you and cross your bent right leg over the knee of your left leg. Place your elbow over your right knee and twist slightly until you feel a stretch in the back of your thigh and gluteal muscle. Hold for 30 seconds and repeat 3 times. You may also try simply bringing a bent leg toward your chest and holding.

Quadriceps Sets
Sit on the floor with your injured leg straight in front of you. Press the back of your knee down while tightening the muscles on the top of your thigh. Hold this position for 5 seconds. Complete 3 sets of 10.

Straight Leg Raise
Sit on the floor with the injured leg straight and the other leg bent, foot flat on the floor. Pull the toes of your injured leg toward you while pressing the back of your knee down and tightening the thigh muscles. Raise your leg 6–8 inches off the floor and hold for 5 seconds, then slowly lower it back to the floor. Complete 3 sets of 10.

Abduction
Lie on your uninjured side, leaning on the elbow of your uninjured side and using the arm of the injured side in front of you to stabilize your body. Slowly lift the injured leg up, hold for 5 seconds, then lower slowly. Keep your hips steady and do not roll forward or backward. Complete 3 sets of 10.

Adduction
Lie on your injured side with your top leg bent and your foot placed flat in front of the injured leg, which remains straight. Raise your injured leg as far as comfortable and hold for 5 seconds. Keep your hips still while lifting. Slowly lower your leg. Complete 3 sets of 10.

Extension
Lie on your stomach. Raise your injured leg as far as comfortable and hold it there for 5 seconds. Keep your hips still while lifting. Slowly lower your leg. Complete 3 sets of 10.

Clamshells
Lie on your side with your knees slightly bent, keeping your legs and ankles together. Open and close your knees like a clam by lifting your top knee until it is parallel with your hip. Keep your feet together throughout the exercise and move slowly and with control, as if someone is pushing against your knee while you press it up. Complete 3 sets of 10.

Advanced Exercises

Only attempt these exercises if you can complete the other exercises with no pain.

Hip Hikes (Advanced Exercise — only if pain-free with others)
Stand with your injured leg on a step while holding onto a wall. Let your opposite hip drop down slightly, then raise it slowly. Complete 3 sets of 10.

When can I return to my sport or activity?

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you
return too soon, you may worsen your injury, which could lead to longer healing times. Everyone
recovers at a different rate. Returning to your sport or activity will be determined by how soon your
knee recovers, not by how many days or weeks it has been since pain began. In general, the longer
you have symptoms before you start treatment, the longer it will take to get better
You may safely return to your sport or activity when, starting from the top of the list and progressing
to the end, each of the following is true:

• You have full range of motion in the injured knee, compared to the uninjured knee
• You have full strength of the injured knee and hip compared to the uninjured knee and hip and
  are able to complete the above exercises without pain
• You can jog straight ahead without pain or limping
• You can sprint straight ahead without pain or limping
• You can jump on both legs without pain, and you can jump on the injured leg without pain
  Return to your sport at about 50% effort, and increase by about 10% each week. If you begin with
  pain, you may need to rest for a few days before returning to activities.

Prevention

lliotibial band syndrome is best prevented by warming up properly and doing stretching exercises before sports or other physical activity.