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Iliotibial Band Syndrome

The lliotibial band is a thick stretch of connective tissue that runs down the side of the leg. Used to help stabilize the knee and leg during running, it can become irritated as a result of overuse. The symptoms of IT Band Syndrome can include: swelling at the knee, pain at the hip or outside of the knee or lower thigh which worsens going down stairs, or increased pain with repeated best prevented by warming up properly and doing stretching exercises before sports or other physical activity.

Treatment

  • Place an ice pack over your iliotibial band for 20–30 minutes every 3–4 hours for 2–3 days or until the pain goes away
  • Do an ice massage. Massage your knee with ice by freezing water in a Styrofoam cup. Peel the top of the cup away expose the ice and hold onto the bottom of the cup while you rub the ice over your knee for 5–10 minutes.
  • Take an anti-inflammatory medication, according to your doctor’s prescription.
  • Do the stretching exercise recommended by your doctor or physical therapist.
  • Use of a foam roller can be helpful in stretching this area
  • Your physician may give you an injection of inflammation and pain

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 safety possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity will be determined by how soon your knee recovers, not by how many days or weeks it has been since your injury occurred.

In general, the longer that you have symptoms before you start treatment, the longer it will take you 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:

  • Your injured knee or hip can be fully straightened and bent without pain
  • Your knee and leg have regained normal strength compared to the uninjured knee and leg — You are able to jog straight ahead without limping
  • You are able to do 45 degree cuts
  • You are able to do 90 degree cuts
  • You are able to do 20 yard “figure 8” runs
  • You are able to do 10 yard “figure 8” runs
  • You are able to jump on both legs without pain, and jump on the injured leg without pain

Rehabilitation Exercises

Iliotibial Band Stretch (standing)
Cross your uninjured leg over your injured leg and bend down to touch your toes. Hold this position for 30 seconds. Come back up to the starting position. Repeat three times.

Iliotibial Band Stretch (side leaning)
Standing sideways to a wall, your injured leg toward the inside. 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 10 seconds and repeat. Do 2 sets of 10.

Standing Calf Stretch
Facing a wall, put your hands against the wall at about eye level. Keep the uninjured leg forward and your injured leg back about 12–18 inches behind your uninjured leg. Keep your injured leg straight and your heel on the floor. Next, do a slight lunge by bending the knee of the forward leg. Lean into the wall until you feel a stretch on your calf muscle. Hold this position for 30–60 seconds, and repeat 3 times.

Hamstring Stretch
Lie on your back with your buttocks close to a doorway, and extend your legs straight out in front of you. Raise your injured leg and rest it against the wall next to the door frame. Hold this position for 30–60 seconds, feeling a stretch in the back of your thigh. Repeat 3 times.

Quadriceps Stretch
Stand sideways to a wall, about an arm’s length away from the wall, with your injured leg towards the outside. Facing straight ahead, 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.

Vastus Medialis Oblique 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. Concentrate on tightening the muscles on the inner side of your kneecap. Hold this position for 5 seconds. Repeat 20 times.

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 as far as you can, while pressing the back of your knee down and tightening the muscles on the top of your thigh. Raise your leg 6–8 inches off the floor and hold for 5 seconds. Slowly lower it back to the floor. Repeat this 20 times.

Hip Adduction (sidelying)
Lie on your injured side with your top leg bent and flat foot placed in front of the injured leg, which is kept straight. Raise your injured leg as far as you can comfortably and hold it there for 5 seconds. Keep your hips still while you are lifting your leg. Hold this position for the 5 seconds, and then slowly lower your leg. Repeat 20 times.

Wall Squat with Ball
Stand with your back, shoulders, and head against a wall and look straight ahead. Keep your shoulders relaxed and your feet one foot away from the wall, shoulder width apart. Place a rolled up pillow or a Nerf ball between your thighs. Keeping your head against the wall, slowly squat while squeezing the pillow or ball at the same time. Squat down until your thighs are parallel to the floor. Hold this position for 10 seconds. Slowly stand back up. Make sure you are squeezing the pillow or ball throughout this exercise. Repeat 20 times.

Hip Adduction with Thera-Band
Stand sideways with your injured leg toward a door. Loop the tubing around the ankle of your injured. Anchor the other end of tubing by tying a knot in it, slipping it between the door and the frame about 8–10 inches above the floor, and closing the door. Keeping your injured knee straight, bring your injured leg across your body. Return to the starting position. Repeat 20 times.