Iliotibial Band Syndrome

Quadriceps stretch
Using a towel, or band, lie on your stomach, attach the band to affected

foot, and pull your heel to your butt. Hold this stretch for 1 minute. R
epeat 3
times.
PrincetonUniversity
Athletic MedicineIlliotibial Band Syndrome Protocol
Treatment includes activity modification, stretching, and strengthening
the affected limb. Immediately begin using:
Make sure to elevate the
knee above heart level until
swelling subsides. Always
be sure to ice your knee
down after you complete
your exercises using either
immersion in ice bath, or
wrapping a bag of ice.
Apply for 20 minutes.
E
Elevation
Wrap an elastic bandage
from mid-calf to mid-thigh,
using even pressure. Wear
this if swelling is noticed
until it decreases. C
Compression
Place an ice bag on the
distal knee, or proximal
hip (wherever painful) for
15-20 minutes, or use an
ice bath if available 3-5
times a day for the flrst
24-72 hours.
I
Ice
You should rest from all
activities that cause pain
or limping. Consider using
crutches until you can walk
without pain or limping.
R
RestConsider using a knee
immobilizer for the flrst
1-2 days if painful when
walking.
P
Protection
From
Netter's Sports Medicine
Iliotibial band syndrome (ITBS) is the result of inflammation
and irritation of the distal portion of the iliotibial tendon (see
illustration) as it rubs against the bursa that lies underneath
the tendon and lateral femoral condyle (outer part of the thigh
bone at the knee), or less commonly, the greater tuberosity
(outer part of the thigh bone at the hip). This overuse injury
occurs with repetitive flexion (bending) and extension
(straightening) of the knee. This could also occur because of a
lack of flexibility of the ITB, which can result in an increase in
tension on the ITB during activity.
When experiencing these problems with your knee, it's
important to find ways not to keep it irritated. Occasionally, the
injuries start with a clear-cut onset, like stepping in a hole or
falling on your knee. Usually though it feels like it comes out
of nowhere. This means that you've been gradually creating
the injury over a longer period of time like a few days or
weeks. Something that you do during the day sets it off, but it's
commonly very hard to figure out was exactly is the aggravating
activity. Nonetheless, you've overdone it. Try not to worry if you
can't figure out exactly why your knee got sore. That may not
be necessary to determine in order to get better. The more often you make your
knee sore, the longer it will take
to get better. The inflammation
seldom builds up to a level where it
keeps you in bed, so it"s tempting
to keep up and about on it. This
may keep it stirred up. Try to
avoid all the activities that make
it sore, i.e., sitting with your knee
bent for a long time, walking a
lot, going up and down stairs, or
exercising. While it doesn"t
cause more damage, it does
keep the inflammation from going away. You may nd it helpful
to sit with your knee straight or get up and move around
occasionally. Also, try stairs one step at a time using your
uninjured leg. These knee injuries can be very stubborn before
they get better. The sooner you stop aggravating it, the sooner
you can get back to the activities you like.
The rst phase of exercising begins with these stretches:
Hip flexor stretch
Kneel with affected knee on the ground, same side arm goes back causing
pelvis (hips) to shift forward, and back to extend. Hold for 20-30
seconds.
Repeat 3 times.
Abductor stretch
Prop the inside of your ankle up on a table, lean into the side you'r
e
stretching. Hold for 20-30 seconds. Repeat 3 times.
Hamstring stretch
Prop the back of your heel up on a table, keep your back straight, and l
ean
forward at the hips. Hold for 20-30 seconds. Repeat 3 times.
Dynamic hamstring stretch
Lie on your back, reach hands behind your knee, keep knee at 90-degree
angle, and kick up until you feel stretch. Repeat 15-20 times each si
de.
Sidelying ITBand stretch
On your side, using a towel or band, pull foot back as if stretching
quadriceps, and use the opposite foot to push down on distal part of leg
.
Hold this stretch for 1 minute. Repeat as needed
C stretch for ITBand
Standing, place affected leg behind the good leg, and lean away. Hold for
20-30 seconds. Repeat 3 times.
Glute stretch
Prop the outside of your ankle up on a table, make sure leg is at 90 deg
rees,
keep your back straight, and lean forward at the hips. Hold for 20-30

seconds. Repeat 3 times.






Begin these strengthening exercises once you have completed and feel
comfortable with the stretching protocol:
Straight leg raises in all 4 directions
Lie on your back, bring your foot toward you so quadriceps muscle is
contracted and knee is straight, raise leg up toward ceiling into hip fl
exion.
Repeat this on your side for hip abduction, opposite side for hip adduct
ion,
and on your stomach for hip extension. Do 3 sets of 15 in each direction
.
As this gets easier, you can add weight, or add repetitions.
Hip abduction with foot externally rotated
On your side, with knee straight (quadriceps contracted), raise your l
eg into
hip abduction with leg slightly back, and point your foot towards the ce
iling.
Do 2 sets of 15.
Fire hydrant position
On your side, flex hip, and bend knee to 90 degrees, then lift leg upw
ard
towards ceiling. Do 2 sets of 20.
Hip circles
On your side, with knee straight (quadriceps contracted), complete 20
circles
to the right, and 20 circles to the left.
Standing squat with hip abduction
Begin with a standing squat and add leg lift out to the side. Do 3 sets
of 10.
Begin these functional exercises when you have successfully completed and feel
comfortable with the strengthening exercises:
Sidelying bicycle
On your side, flex hip with knee bent, extend knee, and bring hip into

extension. Repeat 5 times. On your side, extend hip with knee straight,
bend
knee, and bring hip into flexion. Repeat 5 times.
Standing hip abduction/adduction on box
Standing on a box, with affected leg off the end, bring leg out while
pointing toe, and bring leg in while flexing foot. Do 3 sets of 15.
Alternating lunges
Standing, lunge forward alternating right and left leg.