Iliotibial Band

Syndrome

Definition and Home Stretches

Edited by Dr. Ryan Lambert-Bellacov

Iliotibial Band: Definition •The iliotibial band (ITB) is a dense fibrous band running from the lateral pelvis to the lateral

tibial condyle (Gerdy’s Tubercle).

•The ITB receives contributions from the gluteus maximus and the tensor fascia lata muscles.

•The action of the ITB and its associated muscles is to flex, abduct, and medially rotate the

hip. In addition, the ITB contributes to lateral knee stabilization.

•During knee extension the ITB moves anterior, while knee flexion moves the ITB posterior.

http://www.beliefnet.com/healthandhealing/images/si55551499_ma.jpg

ITB Syndrome: Definition

ITB Syndrome is an overuse condition of the distal ITB near the lateral femoral condyle and at Gerdy’s tubercle.

Irritation and inflammation occurs due to the band rubbing over the lateral femoral condyle.

The bursa underlying the ITB is also prone to swelling due to friction. http://www.drpribut.com/sports/itbfriction.gif

ITB Syndrome: Etiology

ITB syndrome is most common in athletes ie. long distance

runners, cyclists, and gymnasts.

Males and females are equally affected, with those between the

ages of 15-50 being most prevalent.

The most vulnerable range of knee flexion for this condition is at

30-40 degrees; this is where the ITB crosses the lateral femoral

condyle.

Most commonly unilateral, yet activities that stress both lower

extremities simultaneously such as horseback riding or skiing

may predispose one to bilateral ITB syndrome.

Potential Causes

Leg length asymmetry

Over/under pronation

Genu varum/valgum

Anatomically thicker

and/or wider ITB

Weak or imbalanced

gluteal, hamstring and

quadriceps muscles.

Tight ITB

Poor shock absorption

Running on hills and

hard surfaces

Over training

Knee instability

Improperly adjusted

bicycle seat or pedals

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Clinical Signs and Symptoms

Lateral knee pain that has increased over the past days or weeks.

Increased pain with downhill running.

Pain occurring during knee extension, just prior to heel strike.

Snapping or squeaking in knee during running and walking.

May be associated with Patellofemoral Pain Syndrome.

Home exercises: Rationale and Goals

Stretching the tight ITB will lengthen the muscles and fascia surrounding it, thus decreasing irritation over areas of friction; It will also release myofascial adhesions.

Proper stretching can lead to more appropriate biomechanics.

Home stretching is an integral portion of ITB syndrome treatment as it helps to maintain long term muscle balance.

Having the patient be active in their treatment will result in a better prognosis.

Stretch #1

Place affected side down

onto 6 inch firm foam

roller.

Use arms and top leg to

support weight.

Roll from hip to just

above knee and back.

Time: ______min/leg

Times per day: ______

Times per week: ______

Stretch #2

Cross affected leg behind

other leg.

Place opposite hand on

hip to stabilize and lean

away from affected leg.

Reach arm overhead.

Hold: _____ seconds

Sets: _____

Times per day: _____ Times per week: _____

* Use wall or table for balance if needed

http://www.sports-injury-info.com/image-files/it-band-stretch.jpg

Stretch #3

Bend and cross affected

leg over other leg.

Hold affected knee with

opposite hand or elbow.

Twist upper body toward

affected leg. Step 1

Step 2

Hold: _____ seconds

Sets: _____

Times per day: _____

Times per week: _____

http://www.nismat.org/ptcor/itb_stretch

Stretch #4

While seated, cross

affected ankle onto

opposite knee.

Lean forward.

Feel stretch in buttock.

Hold: _____ seconds

Sets: _____

Times per day: _____

Times per week: _____

http://z.about.com/d/exercise/1/0/G/j/seatedhipstretch.jpg

Gluteal Strengthening Exercise

https://hvelink.saintlukeshealthsystem.org/library/healthguide/en-us/images/media/medical/hw/h9991140.jpg

Lay on unaffected side.

Raise top leg 45 degrees

with toes pointing

toward the ceiling then

lower.

Keep leg straight and in

line with body.

Repetitions: _____ per leg

Sets: _____

Times per day: _____

Times per week: _____

References

Carnes, M. & Vizniak, N. (2009). Quick Reference Evidence-Based Conditions

Manual: 3rd Edition. Professional Health Systems Inc., Canada, pg. 240-241.

Kendall, F. P. et al. (2005). Muscles: Testing and Function with Posture and Pain: Fifth

Edition. Lippincott Williams and Wilkins, Baltimore, MD, pg. 437-439.

Liebenson, C. (2007). Rehabilitation of the Spine: A Practitioner’s Manual (2nd

Edition). Lippincott Williams and Wilkins, Baltimore, MD

Prentice, W. E. (2006). Arnheim’s Principles of Athletic Training: A Competency-

Based Approach (12th Edition). McGraw-Hill, New York, NY, pg. 646.

Souza, T. A. (2009). Differential Diagnosis and Management For The Chiropractor: 4th

Edition. Jones and Bartlett Publishers, Canada, pg. 409-410.

Emedicine.com: Iliotibital Band Syndrome

(http://emedicine.medscape.com/article/307850-overview)